Association between ventilator-associated events and implementation of acute respiratory distress syndrome (ARDS) ventilator weaning protocol - 14/11/23
, Shreya Batra, BS, Mary Jo Foreman, RN, MBA, MHA, BSN, CIC, Justin Peruchini, BS, Sarah Lopez, BSN, RN, CIC, CRRN, Rian De Guzman, BS, Nancy Rivera, MD, FACS, Todd Hightower, BSN, RN, Cheryl Malone, BSN, RN, CPN, TCRN, Sheri Stucke, PhD, APRNRésumé |
Background |
Acute respiratory distress syndrome (ARDS) is a severe and life-threatening condition that can occur in critically ill patients. Mechanical ventilation is a commonly used intervention with ARDS patients, but weaning patients off the ventilator can be challenging. An ARDSnet-like ventilator weaning protocol was implemented with the goal of reducing triggers for ventilator-associated events (VAEs).
Methods |
The implementation of the new protocol was used to complete a retrospective investigation of patient outcomes for 1,233 ventilator periods. Periods were included between April and December 2022 for any ventilated patient lasting at least 4 days. National Health Care Safety Network VAE criteria were used to surveille the patient data. Triggers were based on the positive end-expiratory pressure increases or fraction of inspired oxygen (FiO₂) increases. The preset weaning criteria was a reduction by 2 cmH2O per 24 hours.
Results |
Of the total 1,233 individual ventilator periods, VAE criteria were met in 10%. Of the total 126 periods with VAE, 39.2% met the criteria for appropriate protocol implementation. There was a statistically significant relationship between VAE identification and implementation of the protocol.
Conclusions |
The implementation of a protocol for ventilator weaning affects the outcome of developing a VAE. The findings emphasize the importance of implementing the ARDS weaning protocol as a template to reduce the triggers for VAEs and improve overall patient outcomes.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Ventilator weaning protocols decrease variations in clinical practice. |
• | Weaning protocols decrease ventilator-associated events. |
• | Decreasing ventilator-associated events improves patient outcomes. |
Key Words : Mechanical ventilation, Infection related ventilator-associated complications (IVAC), Possible ventilator-associated pneumonia (PVAP), Trauma, Ventilator-associated condition (VAC), Burn
Plan
| Funding/support: This research was supported (in whole or in part) by HCA health care and/ or an HCA health care affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA health care or any of its affiliated entities. |
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| Conflicts of interest: None to report. |
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| Ethical approval: Data access to the secondary data set required permission via a publisher clearing process through the company submitted by the primary author. Confidentiality, honesty, and integrity in all data gathering, storage, and use were consistently maintained. All data were kept secured via password protection for at least 5 years. |
Vol 51 - N° 12
P. 1321-1323 - décembre 2023 Retour au numéro
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