Comparison of the effects of clinical observation and protocol-based weaning on antioxidant stress factors

We aimed to compare the effects of observation of the physician (POB) or by adhering to the protocol-based (PB) weaning methods on total antioxidant capacity (TAC) and total oxidative stress (TOS) levels and weaning success levels.

Our study was conducted on patients admitted from the emergency department between January 2015 and January 2018 in the intensive care unit of our hospital. During the spontaneous breathing trial (SBT), when one of the criteria specified in developed, SBT was terminated and the previous mechanical ventilator parameters were returned. The patient was planned to be taken to SBT again the next morning. If the SBT was successful, extubation was decided. The extubation decision based on physician observation was made according to the patient's state of consciousness and adequate chest expansion during the daily visit.

The decrease in TAC average value before and after extubation was found to be significant in the POB group patients (p=0.001). The decrease in the average TAC value of the PB group patients before and after extubation was found to be significant (p=0.03).

In our study, TAC values were found to be higher in the PB group than in the POB group, and in addition, the reintubation rate was found to be lower. We think that the management of weaning as a PB may contribute to maintaining the balance between TAC and TOS and reduce the rate of reintubation.