Aggressive weaning in cardiac surgical patients

Dimens Crit Care Nurs. 1996 Jul-Aug;15(4):181-6. doi: 10.1097/00003465-199607000-00002.


Nursing management of cardiac surgical patients has changed dramatically over the last several years. The need for cost-effective care with quality patient outcomes has forced critical care nurses to re-evaluate the standard of practice for postoperative cardiac patients. The authors describe the implementation of a fast-track weaning program giving critical care nurses more responsibility for weaning decisions and choice of sedative agent. Our experience in a six-bed Cardiothoracic Recovery Unit (CRU) in a midwestern community hospital evolved from receiving heavily anesthetized patients, continuing sedation postoperatively and prolonged intubation to minimal pharmacologic intervention with propofol and early extubation. In the fast-track weaning protocol, the nurses were given more authority to make critical decisions during the weaning process. This article describes the transition from the traditional time-based weaning system to the fast-track system where individual weaning progress is monitored by the critical care nurses.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / nursing*
  • Critical Care / methods*
  • Critical Pathways
  • Decision Trees
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Male
  • Propofol / therapeutic use
  • Ventilator Weaning / methods
  • Ventilator Weaning / nursing*


  • Hypnotics and Sedatives
  • Propofol