Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Objective: to describe the methods of ventilatory weaning in patients admitted to the Intensive Care Unit of the Hospital Carlos Andrade Marin between november 2012 to march 2013. Methodological design: descriptive observational study from november 2012 to march 2013 that included all patients admitted to the ICU requiring mechanical ventilation. We compared the main ventilatory weaning modalities and use predictive parameters of successful weaning as a checklist, such as FRVT. Results: a total of 78 patients were evaluated in the study, of which 45 (58%) were male and 33 (42%) were females with an average age of 57.7 years, with ranges from 21 to 97 years. 69% of the cases were patients admitted to the unit for a clinical condition, while 31% were those with surgical condition. Ventilatory weaning modes used corresponded to CPAP / PS (continuous positive airway pressure/pressure support by 90%, PC (Pressure Control) 5%, VC (volume control) 4%, and SIMV (synchronized intermittent mandatory ventilation) 1%. Median
time to onset of ventilator weaning was at 5.33 days. The success of overall ventilatory weaning was 47.4%. Conclusions: At the intensive Care Unit HCAM the main mode used for ventilatory weaning in 90% of cases is CPAP with 50% of success rate. The highest percentage for ventilatory weaning failure occurs in patients with chronic lung disease (COPD). Obviously a good choice in ventilatory weaning is the use of predictive testing is the same as FRVT, but that should follow a
ventilator weaning process guideline including the initiation of weaning trial and of use spontaneous ventilation and extubation criteria.
McConville J, Kress J. Weaning Patients from the Ventilator. N Eng J Med, 2012; 367:122-128
Esteban A, Frutos F, Tobin M, et al. A comparison of four methods of weaning patients from mechanical ventilation. N Eng J Med, 1995; 332:345-50
Martin J Tobin. Advances in mechanical ventilation. N Eng J Med, 2002; 344:20-25
Cook D, Rocker G, Withdrawal of Mechanical Ventilation in Anticipation of Death in the Intensive Care Unit. N Eng J Med, 2009; 349:18-22
Blackwood B, Burns K. Use of weaning Protocols for Reducing Duration of Mechanical Ventilation In Critically Adult Patients. BMJ, 2011; 231:330-312
Nicholas A, Smyrnios M, Connolly A. Effects of a Multifaceted, Mutidisciplinary, Hospital-Wide Quality Improvement Program on Weaning From Mechanical Ventilation. Crit Care Med, 2012; 30:6-12
Copper M. ARDS and Weaning From Mechanical Ventilation. Crit Care Med, 2001; 12:3-8
Reardon C. Optimal Modes of Ventilation for Weaning. Crit Care Med, 2009; 4:22-30
Rabiya S, Tuma D. Daily Breathing and Awakening Test Speed Weaning From Mechanical Ventilation. Crit Care Med, 2008; 7:17- 24
George G, Burton M. Weaning Protocols and Bilevel (BiPAP) Ventilation. BMJ, 2010; 26:2-6
Parid P, Jonathan C, Jeremy C. Successful Use of Biventricular Pacing to Facilitate Weaning From Mechanical Ventilation in a Patient With Severe Left Ventricular Failure. B J Cardio, 2011;13:23-28
Suzanne E, McLean M, Louise A. Improving Adherence to a Mechanical Ventilation Weaning Protocol for Critically Ill Adults. Outcomes After an Implementation Program. Am J Crit Care, 2006; 15:36-44
Reardon C. Weaning and Pressure Suport Ventilation. Crit Care Med, 2002; 3:11-16
Chia-Lin-H, Jih –Shuin J. Timing of Tracheostomy as a Determinant of Weaning Succes in Critically Patients. Crit Care Med, 2009; 1:13-15
Sellares J, Acerbi I, Loureiro R. Respiratory Impedance During Weaning From Mechanical Ventilation in a Mixed Population of Crtically Patients. Br J Anest, 2010; 3:34-38
Barclay L. Noninvasive Ventilation Helpful in Persistent Weaning Failure. Crit Care Med, 2006; 4:21-25
Greg M, Metha S. Daily Sedation Interruption in Mechanically Ventilated Critically Patients Cared for With a Sedation Protocol. JAMA, 2012; 308:56-60
ManuelIregui M, Suzanne W, Dametta C. Use of a Handheld Computer by Respiratory Care Practitioners to Improve the Efficiency of Weaning Patients From Mechanical Ventilation. BMJ, 2008; 30:9-13
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