Patient Responses to Weaning from Mechanical Ventilation in Older Critically Ill Patients: a Pilot Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/160521
Type:
Presentation
Title:
Patient Responses to Weaning from Mechanical Ventilation in Older Critically Ill Patients: a Pilot Study
Abstract:
Patient Responses to Weaning from Mechanical Ventilation in Older Critically Ill Patients: a Pilot Study
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2002
Author:Epstein, Carol
P.I. Institution Name:Case Western Reserve University
Title:Assistant Professor
Contact Address:Frances Payne Bolton School of Nursing, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA
Contact Telephone:216.368.6327
Background: In 1994, the National Study Group (NSG) on Mechanical Ventilation, sponsored by the American Association of Critical-Care Nurses (AACN), published an organizing framework for the study of issues related to weaning from mechanical ventilation. In 1998, the NSG disseminated the Weaning Continuum Model (WCM), a process-oriented conceptualization of weaning that incorporates three stages of weaning, predictors of weaning, and patient responses. The need for descriptions of actual patient trajectories to test the validity of the WCM was stressed in order to assist clinician decision-making. The Study Group recommended that research is needed that examines the effects of multidimensional factors as well as their relative contributions to the weaning process from short-term mechanical ventilation. Objectives: The purpose of this pilot study was to describe patient responses over time, including indices of myocardial function, gas exchange, and metabolic stress, among elderly patients who were unable to wean from mechanical ventilatory support (MVS). Methods: A prospective design was used to study 10 trauma and surgical patients who were > 60 years of age, who were receiving short-term MVS, and who were unable to successfully wean by day three of active weaning. Patients were monitored until the patient reached the weaning outcome stage or the study endpoint of 14 days. Results: Eight patients were able to wean successfully. Five patients were weaned prematurely and required re-intubation. Multiple factors having the potential to affect weaning readiness were present, were outside normal limits, and were not respiratory-specific. Conclusion These findings point out the inadequacy of relying solely on respiratory variables during assessment of weaning readiness and lend further support to previous investigators who have recommended a comprehensive approach to weaning.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatient Responses to Weaning from Mechanical Ventilation in Older Critically Ill Patients: a Pilot Studyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160521-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patient Responses to Weaning from Mechanical Ventilation in Older Critically Ill Patients: a Pilot Study</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Epstein, Carol</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Frances Payne Bolton School of Nursing, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">216.368.6327</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">cde2@po.cwru.edu</td></tr><tr><td colspan="2" class="item-abstract">Background: In 1994, the National Study Group (NSG) on Mechanical Ventilation, sponsored by the American Association of Critical-Care Nurses (AACN), published an organizing framework for the study of issues related to weaning from mechanical ventilation. In 1998, the NSG disseminated the Weaning Continuum Model (WCM), a process-oriented conceptualization of weaning that incorporates three stages of weaning, predictors of weaning, and patient responses. The need for descriptions of actual patient trajectories to test the validity of the WCM was stressed in order to assist clinician decision-making. The Study Group recommended that research is needed that examines the effects of multidimensional factors as well as their relative contributions to the weaning process from short-term mechanical ventilation. Objectives: The purpose of this pilot study was to describe patient responses over time, including indices of myocardial function, gas exchange, and metabolic stress, among elderly patients who were unable to wean from mechanical ventilatory support (MVS). Methods: A prospective design was used to study 10 trauma and surgical patients who were &gt; 60 years of age, who were receiving short-term MVS, and who were unable to successfully wean by day three of active weaning. Patients were monitored until the patient reached the weaning outcome stage or the study endpoint of 14 days. Results: Eight patients were able to wean successfully. Five patients were weaned prematurely and required re-intubation. Multiple factors having the potential to affect weaning readiness were present, were outside normal limits, and were not respiratory-specific. Conclusion These findings point out the inadequacy of relying solely on respiratory variables during assessment of weaning readiness and lend further support to previous investigators who have recommended a comprehensive approach to weaning.</td></tr></table>en_GB
dc.date.available2011-10-26T23:01:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:01:24Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.