A weaning protocol administered by critical care nurses for the weaning of patients from mechanical ventilation.
OBJECTIVE
The primary objective of this clinical trial of patients on mechanical ventilation was to determine if a weaning protocol implemented solely by nurses could reduce the weaning time relative to usual care (UC).


METHODS
This study is a prospective, randomized, controlled trial conducted from January 2007 to January 2009 that compared protocol-based weaning (PBW) with UC. A total of 122 patients who received invasive ventilation in the medical ICU of the Asan Medical Center were examined. Nurses operated the mechanical ventilators according to a predesigned ventilator-weaning protocol for the PBW group (n = 61), and intensive care unit (ICU) physicians managed weaning in the UC group (n = 61).


RESULTS
There were no significant differences in the 2 groups at baseline. The number of patients who successfully discontinued mechanical ventilation was similar in the 2 groups (PBW, 46 patients, 75.4%; UC, 47 patients, 77.0%; P = .832). The weaning time was 47 hours (interquartile range, 24-168 hours) in the UC group and 25 hours (interquartile range, 5.75-134 hours) in the PBW group (P = .010).


CONCLUSIONS
The weaning protocol administered by the nurses was safe and reduced the weaning time from mechanical ventilation in patients who were recovering from respiratory failure.
Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
Jae Hyung
JH
Roh
Ara
A
Synn
Chae-Man
CM
Lim
Hee Jung
HJ
Suh
Sang-Bum
SB
Hong
Jin Won
JW
Huh
Younsuck
Y
Koh
D000368:Aged; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D011446:Prospective Studies; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods* / Q000451:nursing*