Source: Annual Congress 2002 - Monitoring respiratory parameters in critically ill patients
Disease area: Respiratory critical care

Abstract

Background Duration of mechanical ventilation becomes longer than necessary because of failure to objectively assess patients' ability to breathe spontaneously. Systematic evaluation may lead to earlier removal of ventilator assistance.
Method Eligible patients were subjected to daily monitoring of spontaneous breathing parameters. Physicians of patients randomized to the intervention group were informed if their patient achieved a rapid shallow breathing index (RSBI) of [lte]105, and were asked permission to proceed with a 2-hour T-piece trial of spontaneous breathing. Consent for extubation was obtained if the 2-hour trial was successful. In the control group, no further actions were taken after measuring respiratory parameters. Weaning strategy, and decision to extubate were left to the physicians of both groups.
Results There were 14 patients in the control group and 12 in the intervention group. Baseline characteristics were similar. The median duration of mechanical ventilation was 1 day in the intervention group and 2 days in the control group (p=0.013). Median duration of ICU stay was 5 days in the control group and 3 days in the intervention group (p value=0.033). After adjustment with a Cox regression model, randomization assignment was the only significant predictor of duration of mechanical ventilation (p= 0.034) and ICU stay (p=0.020). There was no significant difference in the number of hospital days and 30-day in-hospital mortality rate.
Conclusion Daily screening of respiratory parameters followed by a protocol of physician notification and a request for trial of spontaneous breathing resulted in a shorter duration of mechanical ventilation and ICU stay as compared controls.

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Citations should be made in the following way:
M. L. T. Due, G. D. Dy, L. J. H. Santo Tomas (Quezon City, The Philippines). The effect of daily screening and physician notification on the duration of mechanical ventilation. Eur Respir J 2002; 20: Suppl. 38, 620

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