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Decrease in ventilation time with a standardized weaning process.

H M Horst·D Mouro·R A Hall-Jenssens·N Pamukov
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Abstract

OBJECTIVE: To test the hypothesis that standardizing the process of weaning from mechanical ventilation would decrease ventilation times and length of stay in a surgical intensive care unit. DESIGN: Comparison of historic ventilation times with physician-directed weaning with those obtained with protocol-guided weaning by respiratory therapists. SETTING: Urban, teaching surgical intensive care unit with open admission policy and no dominant diagnosis related group. RESULTS: From January 1, 1995, through December 31, 1995, 378 patients who underwent physician-directed weaning from a ventilator had 64488 hours of ventilation, compared with 57796 ventilation hours in 515 patients with protocol-guided weaning (April 1, 1996, through May 31, 1997). The mean hours of ventilation decreased by 58 hours, a 46% decrease (P<.001). The length of hospital stay decreased by 1.77 days (29% change), while the Acute Physiology and Chronic Health Evaluation III score remained at 50 to 51. The number of reintubations did not change. The marginal cost savings was $603580. CONCLUSION: Protocol-guided weaning from mechanical ventilation leads to more rapid extubation than physician-directed weaning and has great potential for cost savings.

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APACHEClinical ProtocolsHumansIntensive Care UnitsLength of StaySurgery Department, HospitalTime FactorsVentilator WeaningJournal Article

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H M Horst, D Mouro, R A Hall-Jenssens, N Pamukov. 1998. Decrease in ventilation time with a standardized weaning process.. https://doi.org/10.1001/archsurg.133.5.483

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