Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
J Crit Care. 2012 Dec;27(6):549-55. doi: 10.1016/j.jcrc.2011.11.008. Epub 2012 Jan 9.
The primary objective of this clinical trial of patients on mechanical ventilation was to determine if a weaning protocol implemented solely by nurses could reduce the weaning time relative to usual care (UC).
This study is a prospective, randomized, controlled trial conducted from January 2007 to January 2009 that compared protocol-based weaning (PBW) with UC. A total of 122 patients who received invasive ventilation in the medical ICU of the Asan Medical Center were examined. Nurses operated the mechanical ventilators according to a predesigned ventilator-weaning protocol for the PBW group (n = 61), and intensive care unit (ICU) physicians managed weaning in the UC group (n = 61).
There were no significant differences in the 2 groups at baseline. The number of patients who successfully discontinued mechanical ventilation was similar in the 2 groups (PBW, 46 patients, 75.4%; UC, 47 patients, 77.0%; P = .832). The weaning time was 47 hours (interquartile range, 24-168 hours) in the UC group and 25 hours (interquartile range, 5.75-134 hours) in the PBW group (P = .010).
The weaning protocol administered by the nurses was safe and reduced the weaning time from mechanical ventilation in patients who were recovering from respiratory failure.
本项针对接受机械通气患者的临床试验的主要目的是确定仅由护士实施的撤机方案是否能较常规护理（UC）缩短撤机时间。
本研究为 2007 年 1 月至 2009 年 1 月进行的前瞻性、随机、对照试验，比较了基于方案的撤机（PBW）与 UC。共检查了在 Asan 医疗中心内科重症监护病房接受有创通气的 122 例患者。在 PBW 组（n=61）中，护士根据预先设计的呼吸机撤机方案操作机械呼吸机，而在 UC 组（n=61）中，重症监护病房医师管理撤机。
两组患者在基线时无显著差异。两组成功停用机械通气的患者数量相似（PBW，46 例，75.4%；UC，47 例，77.0%；P=.832）。UC 组撤机时间为 47 小时（四分位距，24-168 小时），PBW 组为 25 小时（四分位距，5.75-134 小时）（P=.010）。
正在恢复呼吸衰竭的患者，由护士执行的撤机方案安全且缩短了机械通气撤机时间。
