A multidisciplinary team approach to weaning from prolonged mechanical ventilation

作者：Black Claire J^*; Kuper Martin; Bellingan Geoff J; Batson Steve; Matejowsky Claire; Howell David C J

来源：British Journal of Hospital Medicine, 2012, 73(8): 462-466.

Objective: To establish whether multidisciplinary team-led strategies to maintain continuity across the weaning process result in an increase in the proportion of patients surviving prolonged mechanical ventilation and reduce the length of time patients are ventilated.
Design: A quality improvement programme was conceived and implemented for patients receiving mechanical ventilation for >= 21 days.
Setting: University teaching hospital general intensive care unit.
Interventions: The introduction of long-term weaning plans.
Measurements and main results: intensive care unit survival odds ratio and 95% confidence interval 0.181 (0.06-0.49) P<0.01 and hospital survival odds ratio and 95% confidence interval 0.2 (0.08-0.61) P<0.01. Duration of mechanical ventilation (median and 95% confidence interval) 53 days (32-74) vs 42 days (39-44) P=0.03.
Conclusions: long-term weaning plans led by a multidisciplinary team were associated with a reduction in intensive care unit and hospital mortality, and duration of mechanical ventilation in patients ventilated for >= 21 days. Strategies to maintain continuity in this complex patient group are likely to be fundamental to improving outcome.

• 出版日期2012-8