title: A multidisciplinary team approach to weaning from prolonged mechanical ventilation.
abstract: OBJECTIVE
  To establish whether multidisciplinary team-led strategies to maintain continuity across the weaning process result in an increase in the proportion of patients surviving prolonged mechanical ventilation and reduce the length of time patients are ventilated.
  
  
  METHODS
  A quality improvement programme was conceived and implemented for patients receiving mechanical ventilation for >21 days.
  
  
  METHODS
  University teaching hospital general intensive care unit.
  
  
  METHODS
  The introduction of long-term weaning plans.
  
  
  RESULTS
  Intensive care unit survival odds ratio and 95% confidence interval. 0.181 (0.06-0.49) P<0.01 and hospital survival odds ratio and 95% confidence interval 0.2 (0.08-0.61) P<0.01, Duration of mechanical ventilation (median 95@ confidence interval ) 53 days (32-37) vs 43 days (39-44) P=0.03.
  
  
  CONCLUSIONS
  Long-term weaning plans led by a multidisciplinary, team were associated with a reduction in intensive care unit and hospital mortality, and duration of mechanical ventilation in patients ventilated for ≥ 21 days. Strategies to maintain continuity in this patient parent group are likely fundamental to improving outcome.
authors.affiliation: UCL Hospitals NHS Foundation Trust, London NW1 2BU, UK. claire.black@uclh.nhs.uk
authors.forename: Claire J
authors.initials: CJ
authors.lastname: Black
authors.forename: Martin
authors.initials: M
authors.lastname: Kuper
authors.forename: Geoff J
authors.initials: GJ
authors.lastname: Bellingan
authors.forename: Steve
authors.initials: S
authors.lastname: Batson
authors.forename: Claire
authors.initials: C
authors.lastname: Matejowsky
authors.forename: David C J
authors.initials: DC
authors.lastname: Howell
mesh_terms: D018806:APACHE; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D033183:Interdisciplinary Communication; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D012737:Sex Factors; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods*