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Related Experiment Videos

Outcomes in post-ICU mechanical ventilation: a therapist-implemented weaning protocol.

D J Scheinhorn1, D C Chao, M Stearn-Hassenpflug

  • 1Barlow Respiratory Hospital and Research Center, Los Angeles, CA, USA. djs@barlow2000.org

Chest
|February 7, 2001
PubMed
Summary

A new therapist-implemented patient-specific (TIPS) protocol significantly reduced the time to wean patients from prolonged mechanical ventilation (PMV) in a long-term acute-care setting, with similar patient outcomes compared to historical controls.

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Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Pulmonology

Background:

  • Therapist-implemented protocols are utilized for mechanical ventilation weaning in intensive care units.
  • Barlow Respiratory Hospital (BRH), a long-term acute-care (LTAC) facility, specializes in weaning patients from prolonged mechanical ventilation (PMV).
  • A therapist-implemented patient-specific (TIPS) protocol was developed at BRH to standardize PMV weaning.

Purpose of the Study:

  • To evaluate the effectiveness of a newly developed therapist-implemented patient-specific (TIPS) weaning protocol.
  • To compare the time to wean and patient outcomes in patients treated with the TIPS protocol versus historical controls.
  • To assess the impact of a standardized protocol on weaning patients from prolonged mechanical ventilation in an LTAC setting.

Main Methods:

Related Experiment Videos

  • A prospective cohort study with a historical control group was conducted.
  • A TIPS weaning protocol was developed based on scientific evidence and expert consensus, incorporating LTAC weaning procedures.
  • The protocol was implemented hospital-wide after staff training and pilot data analysis, with monitoring for outcomes, variances, and compliance.

Main Results:

  • The study included 252 patients undergoing weaning from PMV, compared to 238 historical controls.
  • Median time to wean decreased significantly from 29 days in the control group to 17 days in the TIPS protocol group (p < 0.001).
  • Patient outcomes at discharge were comparable between groups: weaned (54.7% vs 58.4%), ventilator-dependent (17.9% vs 10.9%), and mortality (27.4% vs 30.7%).

Conclusions:

  • The therapist-implemented patient-specific (TIPS) protocol significantly reduced the time to wean patients from prolonged mechanical ventilation.
  • Patient outcomes remained comparable between the TIPS protocol group and the historical control group.
  • High compliance with the TIPS protocol supports its role in achieving improved weaning times in LTAC facilities.