Abstract
Introduction: Specialist weaning centres reduce bed days within critical care for patient undergoing prolonged mechanical ventilation PMV. Most weaning centres follow a medically led-nursing supported model. We have developed a nursing led-medically supported model for PMV patients in a 'cold' weaning site that has video linking and electronic noting to allow enhanced communication with the acute 'hot' site.
Aims: Our aim was to assess the safety and clinical effectiveness of such a model of care.
Methods: A retrospective analysis with prospective data inputted into an electronic patient record.
Results: 35 patients were admitted for weaning spending a median 103 (22-188) days on the specialist unit. 25 patients had neuromuscular disease, 5 obesity related respiratory failure, 2 COPD and 3 other causes of PMV. 20 patients were decannulated with 18 requiring initiation of non-invasive ventilation. 28 patients were discharged home, 4 to nursing homes and 3 to local hospitals for rehabilitation. During the weaning process 12 patients required transfer back to the main weaning centre: 6 for acute complications and 6 for specialist input.
Discussion: Weaning from PMV remains a lengthy process and requires specialist input and is interspersed with variable clinical course. This novel approach to PMV weaning has proven successful as the majority of patients were discharge without a tracheostomy to their own homes.
- Copyright ©the authors 2016
