Girard Timothy D, Ely E Wesley
Division of Allergy, Pulmonary, and Critical Care Medicine, Center for Health Services Research, Vanderbilt University School of Medicine, 6(th) Floor MCE, #6110, Nashville, TN 37232-8300, USA.
Clin Chest Med. 2008 Jun;29(2):241-52, v. doi: 10.1016/j.ccm.2008.02.004.
Though seminal clinical trials have identified efficacious methods of liberating patients from mechanical ventilation (ie, weaning), this knowledge is not applied often by physicians in routine practice. Weaning protocols are a strategies by which research results can be translated effectively and efficiently into clinical practice, but results of clinical trials evaluating weaning protocols have not been uniform, and controversy continues to surround this important area in critical care medicine. This article reviews the rationale for and against the routine use of weaning protocols and highlights informative details of many clinical trials that have evaluated such protocols.
尽管一些具有开创性的临床试验已经确定了将患者从机械通气(即撤机)中解放出来的有效方法,但医生在日常实践中并不经常应用这些知识。撤机方案是一种可以将研究结果有效且高效地转化为临床实践的策略,但评估撤机方案的临床试验结果并不一致,重症医学这一重要领域仍存在争议。本文回顾了支持和反对常规使用撤机方案的基本原理,并重点介绍了许多评估此类方案的临床试验的详细信息。