جستجوی مقالات مرتبط با کلیدواژه "weaning from mechanical ventilation" در نشریات گروه "پزشکی"

The aim of this study was to determine the effect of changes in respiration rate on the outcome of weaning from mechanical ventilation in patients admitted to the intensive care unit of Golestan Hospital in Ahvaz in 2020.

The present study was a cross-sectional and analytical study. The statistical population of the study was all patients under mechanical ventilation admitted to the intensive care unit of Golestan Hospital in Ahvaz from April to June 2020. The sample size in the present study was 135 people. SPSS 24.0 software was used for data analysis. The significance level for all tests was 0.05.

The highest frequency of the need for mechanical ventilation in the studied patients was postoperative, acute brain injury and respiratory distress. Based on the findings of the present study, a total of 52.6% of patients under mechanical ventilation had successful separation. The cut-off rate of respiration for successful separation from mechanical ventilation was RR > 20. According to the findings, for approximately 67% of patients with RR <20, the result of separation from mechanical ventilation was successful, and for 60% of patients with RR> 20, the result of separation was unsuccessful. Sensitivity and specificity were obtained by determining the cut-off RR > 20 equal to 70% and 60%. In other words, 70% of patients with unsuccessful separation resulted in RR> 20 and 60% of patients with successful outcome had RR <20.

Based on the results of the present study, the respiratory rate had a significant relationship with the result of weaning from mechanical ventilation. Patients with high respiratory rate have deliberately had the result of weaning from poor mechanical ventilation. Also, the sensitivity in the present study was obtained with a cut of RR> 20 times 70%. 60 percent of patients who had more than 20 breaths had a successful separation outcome.

Usage of indicators to predict the outcome of weaning from the ventilator is a controversial issue. An index with high diagnostic accuracy can properly identify the Patients ready for weaning from mechanical ventilation and prevents premature weaning and its complications. Two of the introduced weaning indicators are RSBI and CROP but their predictive value in predicting the outcome of weaning from mechanical ventilation is different or contradictory.
This study was to Compare RSBI and CROP in predicting the outcome of weaning from mechanical ventilation in patients admitted to ICU.
This prospective, single-blind study was performed on 80 adult patients who were on mechanical ventilation for more than 24 hours in 3 ICUs (Internal-General-stroke) of Mashhad Ghaem hospital from October 2015 to May 2016. All the patients ready for weaning were identified and studied in one group. All of them were ventilated with PSV mode with minimum support for 30 mins. If the patient’s vital signs were stable during those 30 mins, we measured the required respiratory variables and arterial blood gas values to calculate CROP and RSBI. Then the SBT was performed, with a T-piece for 120 mins. finally the diagnostic accuracy of each index was evaluated according to the weaning outcome and prediction of indexes.
There were 57 successful and 23 unsuccessful weaning cases. The specificities were CROP 0.85 and RSBI 98.2. The sensitivities were CROP 0.75 and RSBI 0.26. The diagnostic accuracy were CROP 85.2 and RSBI 77.5. The new threshold value obtained in this study was very different for RSBI.
According to the analysis performed by the cut-off points obtained in previous studies, CROP index has the highest diagnostic accuracy, sensitivity and specificity were both high. The cut-off point of RSBI previously reported for non-homogeneous patients population is not extensible to all with different etiologies.

Weaning from mechanical ventilator is one of the most challenging issues of hospitalized chronic obstructive pulmonary patients in intensive care unit. Introducing new index to anticipate the patient's weaning from mechanical ventilator with more successful probability is so paramount. The study had two-fold purposes including 1. Determining cut-off points of vahedian one and common indices RSBI, P0.1, NIF, CROP, and IWI in the population of chronic obstructive pulmonary patients; and 2. Comparing different weaning factors from mechanical ventilator of vahedian one and RSBI, P0.1, NIF, CROP, and IWI indices in the population of chronic obstructive pulmonary patients.
Present study was an observational, prospective multi center trible blinded clinical trial that conducted from January 2013 to March 2014 in the population of hospitalized chronic obstructive pulmonary patients in critical care unit's of selected hospitals in Tehran in two groups including cut off points determining group (n = 90) and determining different predicting weaning factors from mechanical ventilator group (n= 90). The process of weaning from mechanical ventilator conducted same in both groups and was based on the defined protocol. ROC analysis used to determine cut off points in the first group and predicting factors in the second group.
Six indices Vahedian one, RSBI, IWI, P0.1, NIF, and CROP were comparing from different predicting weaning factor's view. Generally, RSBI, vahedian one, IWI, P0.1, NIF, and CROP indices were devoted the most favorably factors to itself, respectively. The highest area under the curves were devoted to RSBI (0.927) and vahedian one (0.888) indices.
Although the proposed index than other common indices has more components in weaning process from mechanical ventilator, but RSBI index in addition to simply, devoted to itself the most desirable characteristics of predictive weaning from mechanical ventilator. Furthermore, it is suggested that RSBI index use along with subjective, objective, and respiratory distress symptoms monitoring in the population of chronic obstructive pulmonary patients.

The results of previous studies show the neonate position is effective in improving oxygenation. Therefore, this study aimed to compare the prone and supine positions on oxygen saturation in preterm infants who were weaned from mechanical ventilation. This clinical trial carried out on 40 preterm infants who were weaned from mechanical ventilation in the neonatal intensive care unit (NICU) of Afzalipour hospital of kerman. Infants were placed for 3 hours in each state. Oxygen saturation were recorded every 15 minutes in the two-part list. Data were analyzed by using repeated measurements and paired t -test The findings showed that the average oxygen saturation in the prone position was significantly (96.15±1.96) higher than the average oxygen saturation in the supine position (95.49±1.96) (p<0.001(. According to the findings and to be higher average oxygen saturation in the prone position, nurses can use the appropriate position in preterm infants weaned from mechanical ventilation to improve their oxygenation.

Nurse's participation in clinical affairs improves patient care and reduces costs. Also, the lack of correct and timely decisions can prolong the treatment and care for patients and create problems. The aim of study was to determine the effect of nurse's participation in patient weaning from mechanical ventilator and on its outcomes on patients hospitalized in intensive care units in Esfahan Al-Zahra Hospital. This is a clinical trial in which 50 patients connected to mechanical ventilators for more than 48 h were selected through convenient sampling and were randomly divided into two groups of 25 subjects. In the Intervention group patients were prepared for weaning by trained nurses three times in every 24 hours using Burn’s wean assessment program in three shifts. Control group weaning followed the conventional care unit procedures. Findings were analyzed using descriptive and inferential statistical methods (t-test, chi-square and Fisher's exact). The findings showed that length of MV (P=0.03), length of staying time in intensive care units (P=0.006) and the weaning failure from mechanical ventilator (P=0.01) were all significantly different in the two groups; however, the average arterial oxygen saturation 2 hours after removal from mechanical ventilation was not significantly different between intervention and control group. The results showed that nurse participation in the weaning process of the patients from mechanical ventilator is a safe method in day time and shortens the length of MVT and length of staying in ICU and, reduces the weaning failure compared to the conventional methods.