[TISS-28 in difficult to wean patients after long-term mechanical ventilation].
OBJECTIVE
To compare the Therapeutic Intervention Scoring System (TISS) 28 in difficult to wean patients before and after transfer to a weaning center.


METHODS
Using TISS-28, the authors investigated the difference between regular intensive care units (ICUs) and the respiratory ICU (RICU) of their hospital in difficult to wean patients after long-term mechanical ventilation (MV). Special emphasis was placed on the appropriateness of TISS-28 to cover the specific weaning activities. 63 tracheotomized patients ventilated for more than 14 days were included.


RESULTS
In total, 15.9% of patients were not weaned, 20.6% of population was successfully weaned with noninvasive ventilation (NIV), and 63.5% of patients was successfully weaned without NIV. The transfer of patients from other ICUs to a weaning facility resulted in a significant reduction of total TISS-28 from 29.5 to 23.8 points (p<0.001) on average.


CONCLUSIONS
The high weaning success rate in a specialized facility is associated with a significant reduction of TISS-28 scores. The use of TISS-28 in a weaning center for patients with prolonged MV to measure workload does not adequately mirror the efforts by physicians, nurses, physiotherapists, and other health-care personnel.
Schönhofer
Bernd
B
Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg. bernd.schoenhofer@t-online.de
Harms
Wolf
W
Lefering
Rolf
R
Suchi
Stefan
S
Köhler
Dieter
D
D018806:APACHE; D000368:Aged; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000191:economics*; D008134:Long-Term Care / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000191:economics; D010360:Patient Transfer / Q000191:economics; D012051:Reimbursement Mechanisms / Q000191:economics; D012124:Respiratory Care Units / Q000191:economics*; D015300:Ventilator Weaning / Q000191:economics*