Abstract
Introduction: The duration of mechanical ventilation (MV-duration) should be limited as much as possible to avoid complications.
Objective: The aim of the study was to find out the impact of a daily weanscreen on MV-duration.
Setting: A 20-bed mixed medical-(neuro-)surgical Intensive Care Unit.
Methods: In 2009 the sedationgoal was prescribed each day by the intensivist. In 2010 we introduced a 4 interventions weanscreenprotocol, including: Daily Spontaneous Awakening Trial (SAT), Rapid Shallow Breathing Index (RSBI), Spontaneous Breathing Trial (SBT) and MD enumerates reason to continue. From Januari to December 2010 we assessed all ventilated patients every day from Monday to Friday. The subsequent 4 steps of the weanscreenprotocol were carried out by a ventilation practitioner (R.N.) to promote extubation. The amount of sedatives per year was divided by the number of ventilated patients, resulting in an average dose midazolam/propofol/morphine per patient. The MV-duration was evaluated and compared with 2009.
Results: The 672 patients in 2010 were compared to 594 patients in 2009. SAPSII was the same in both cohorts, Median MV-duration decreased from 42 to 38 hours (n.s. Mann-Witney U test). Together with a small increase in the use of propofol we observed a substantial reduction in the use of midazolam and morphine.
Conclusions: In our population we succeeded in reducing the use of midazolam and morphine by a daily 4 component-weanscreen, and a 10% decrease in MV-duration (statistically n.s.).
- © 2011 ERS
