Effects of the use of mechanical ventilation weaning protocol in the Coronary Care Unit: randomized study

Rev Bras Cir Cardiovasc. Apr-Jun 2011;26(2):213-21. doi: 10.1590/s0102-76382011000200011.
[Article in English, Portuguese]

Abstract

Objective: To compare mechanical ventilation weaning based on a protocol using the spontaneous breathing trial against mechanical ventilation weaning without a standardized protocol in heart patients.

Methods: Prospective, open, randomized study. In 2006, 36 patients undergoing mechanical ventilation for over 24 hours were randomized into two groups: control group - eighteen patients whose mechanical ventilation weaning was performed according to the different procedures adopted by the multidisciplinary team; and experimental group - eighteen patients weaned according to previously established protocol.

Results: Control group patients started the weaning process sooner than experimental group patients (74.7 ± 14.7 hours vs. 185.7 ± 22.9 hours, P=0.0004). However, after the experimental group patients were ready for weaning, the extubation was carried out more rapidly than in the control group (149.1 ± 3.6 min vs. 4179.1 ± 927.8 min, P < 0.0001) with significantly lower reintubation rates (16.7% vs. 66.7%, P = 0.005).

Conclusion: The use of a specific protocol based on the spontaneous breathing trial for mechanical ventilation weaning in heart patients had better outcomes than weaning carried out without a standardized protocol, with shorter weaning times and lower reintubation rates.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Clinical Protocols
  • Coronary Care Units*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors
  • Ventilator Weaning / methods*