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Nurse-led weaning protocols-a systematic review and meta-analysis
Yingying Wang1,2, Yan Wang2, Su Gu3
1Emergency Intensive Care Unit, Yijishan Hospital of Wannan Medical College, Wuhu, China.
Frontiers in Medicine
|August 18, 2025
Summary
Nurse-led weaning protocols significantly reduce mechanical ventilation duration, intensive care unit length of stay, and ventilator-associated pneumonia incidence. Further research is needed to confirm these benefits in diverse patient populations.
Area of Science:
- Critical Care Medicine
- Nursing Science
- Respiratory Therapy
Background:
- Protocol-directed weaning is known to shorten mechanical ventilation (MV) duration.
- Nurse-led weaning protocols show promise in reducing MV duration.
- Widespread implementation and clinical effectiveness of nurse-led protocols remain uncertain.
Purpose of the Study:
- To evaluate the effectiveness of nurse-led weaning protocols compared to physician-led weaning in mechanically ventilated patients.
- To assess the impact of nurse-led protocols on key patient outcomes.
Main Methods:
- Systematic literature search across eleven electronic databases up to January 20, 2024.
- Independent data extraction by two researchers.
- Statistical analyses performed using RevMan 5.1, with evidence certainty assessed by GRADE.
Main Results:
- Nurse-led weaning significantly reduced MV duration (MD = -1.78 days) and intensive care unit length of stay (LOS) (MD = -2.04 days).
- Overall LOS was also reduced (MD = -2.54 days).
- A reduced incidence of ventilator-associated pneumonia (VAP) was observed with nurse-led protocols (OR = 0.54).
Conclusions:
- Nurse-led weaning protocols demonstrate potential in decreasing MV duration, ICU LOS, overall LOS, and VAP incidence.
- Findings should be interpreted cautiously due to moderate-to-low evidence quality and limited study numbers.
- Further high-quality, large-scale research is recommended to validate effectiveness and safety across various clinical settings.
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