Weaning from mechanical ventilation in the intensive care unit is an important step in the treatment process. More patients in less than 6 hours after cardiac surgery can be separated from mechanical ventilation and extubated. However, 20-40% of patients after cardiac surgery, due to dysfunctional ventilator weaning response (DVWR), still remain under mechanical ventilation. Therefore, a new method of mechanical ventilation such as volume assured pressure support ventilation (VAPSV) is needed in order to reduce the time of weaning from mechanical ventilation. To compare the effect of pressure support ventilation (PSV) with volume assured pressure support ventilation (VAPS) on time of weaning from mechanical ventilation in patients after cardiac surgery. This clinical trial study was conducted with the participation of 76 patients undergoing cardiac surgery in Imam Reza hospital of Mashhad, in 2013. Patients were randomly divided into two groups of pressure support ventilation (control) and pressure support ventilation with reliable volume (intervention) groups and the duration of mechanical ventilation and reintubation in both groups was recorded. The data were analyzed by SPSS software version 16 using t-student test and Mann-Whitney tests. The mean duration of mechanical ventilation in VAPS group (65.7±5.8) significantly decreased compared with PSV (87.1± 5.8) (P = 0.015). Results of our study showed that VAPS method could reduce the time of weaning from mechanical ventilation and due to fewer complications; it can be used as an alternative method for weaning off mechanical ventilation.

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.

Weaning from mechanical ventilation is a frequent nursing activity in Intensive Care Unit (ICU). Nature-based sound as a non-pharmacological method was effective in alleviating anxiety and agitation in patients undergoing mechanical ventilation. The aim of this study was to determine the effect of nature-based sound on shortening length of weaning from mechanical ventilation time in patients undergoing Coronary Artery Bypass Graft (CABG) surgery. This is a quasi-experimental study in which 120 patients undergoing CABG surgery had participated. These patients were undergoing weaning from mechanical ventilator; they were randomly divided into two intervention and control groups of 60 subjects. The study was done in 2013. The intervention group listened to nature-based sounds through headphones، immediately after the first trigger، they listened to the sound at 20 min intervals until extubation. Data was collected until twenty three minutes after extubation too. Patients of the control group had headphones with no sound. Data collection tools included a demographic- medical questionnaire and a researcher-made data recording sheet. Data analysis was done through descriptive and inferential statistical methods including independent t-test، chi-square and Fisher''s exact test by using SPSS 16 software. Findings showed that the intervention group had significantly lower length of mechanical ventilation time than the control group (P<0. 001). The results showed that nature-based sound as a non-pharmacological treatment can be effective in shortening length of weaning from mechanical ventilation time and it can be helpful in this process. Since it’s a safe، easy and inexpensive method and it has no complications، it can be used besides other non-pharmacological methods in shortening duration of patients’ weaning from mechanical ventilation in ICU.

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.

The use of nonpharmacological methods has been emphasized in the recent years. These methods are used to decrease the duration of weaning from mechanical ventilation after coronary artery bypass graft (CABG) surgery.
The present study aimed at determining the effect of family-centered care on the duration of weaning from mechanical ventilation in patients undergoing CABG.
This clinical trial study was conducted in Jamaran Heart Subspecialty hospital in Tehran in 2016. Initially, convenient sampling method and random allocation were used by quaternary blocks to allocate patients into 2 groups of experimental and control, with 35 participants in each group. In the intervention group, the patients’ family member chosen by the patient was entered into the ward during the weaning process. Patient’s entrance time to the ward to extubation time was considered as the duration of weaning from mechanical ventilation in the 2 groups.
Duration of weaning in the experimental group was 97 minutes less than the control group; in other words, the weaning duration of those in the control group was 1.4 times greater than those in the experimental group. This difference was statistically significant between the 2 groups (P = 0.05).
Family-centered care reduced the duration of weaning from mechanical ventilator in patients undergoing coronary artery surgery, which can remarkably decrease complications due to ventilation with positive pressure in these patients.

Aassessment of patient readiness for weaning from mechanical ventilation is an important of phase in the weaning process. The aim of this study was to determine the effect of the nurse-directed patient readiness assessment for weaning on duration of mechanical ventilation in the intensive care unit. In this clinical trial study, 50 intensive care units patients who needed mechanical ventilation for more than 48 hours were selected using convenient sampling method, and randomly divided into two 25-person groups. Burn’s weaning readiness assessment questionnaire were used for intervention group, and the control group were weaned from the system according to routine method of the unit. The findings were analyzed with the aid of descriptive statistical methods, independent t-tests, chi-square and Pearson’s correlation. Significance level was considered to be 0.05. The mean duration of mechanical ventilation in the intervention group was significantly lower than that of the control group (p<0.03). Also, there was a significant inverse relationship between Burn’s checklist scores and the duration of mechanical ventilation (p<0.04, r=-0.263). The results of this study showed that assessment of the patient’s readiness for weaning from mechanical ventilation by nurse is a safe method in day time and shortens the duration of mechanical ventilation in intensive care units compared to the routine methods.

Aims: The aim of this study was to examining the Factors affecting the duration of weaning from mechanical ventilation based on nurses guide in the intensive care units.
In this sectional -analytic study and single group , 65 intensive care unit patients who required mechanical ventilation for more than 72 hours were selected by convenience sampling. Patients with Burns Wean Assessment Program tools with the nurses guidance in three shifts were investigated. Patient's age, sex, the cause of the connect to mechanical ventilation, The level of awakening based on the Ramsay sedation scale,and duration of mechanical ventilation were recorded. The SPSS22 was used for conducting statistical tests such as the Descriptive statistics and Indipendent T- tests.
The mean duration of mechanical ventilation based on Burns Wean Assessment Program (the nurses guidance) was 111/75±33/46. The test results showed that confounding factors of Sex (p=0/03) and Ramsay sedation scale scor (p=0/0001) had significant effect on the duration of mechanical ventilation but Age (p=0/2) and the cause of the connect to mechanical ventilation (p=0/319) No significant effect on the duration of mechanical ventilation.
To weaning from mechanical ventilation , more attention should be paid to reducing the time of mechanical ventilation and the impact of confounding factors.

Determining the patient's readiness for weaning from mechanical ventilation and predicting the weaning outcomes are important issues that should be carefully evaluated and the risks of delay in weaning and increased mortality rates should be avoided. The aim of this study was to compare the outcomes of weaning with current and IWIbased methods in patients admitted to the intensive care units. This was a prospective clinical trial - one blind - multicenter study where 124 adult patients, who were mechanically ventilated for more than 24 hours, were evaluated in 2 groups of current and IWI-based methods (62 in each group). Initially, in current method, the rates of successful and unsuccessful weaning were evaluated in 62 patients and the threshold value of IWI was determined. In this group, the readiness for weaning and the decision to return to mechanical ventilation was made by physician in charge (who was completely blind to the result of the indexes evaluated). Then, after training the IWI to the medical team responsible for weaning, in 62 patients of the second group, weaning was made based on this index and the rates of successful and unsuccessful weaning were assessed. Ultimately, the rate of successful and failure weaning of the two groups was compared. In Current method among 62 patients studied, 35 were successful and 27 unsuccessful. APACHE II in successful group was 15.09±5.68, in unsuccessful group 18.70±5.39, Carrico index (PaO2 / FiO2) in successful group was 214.102±40.35, in unsuccessful group 182.87±76.22, DO index (dissolved oxygen (SaO2)) in successful group was 96.74±2.46, in unsuccessful group 95.37±3.28, GCS Score in successful group was 9.57± 1.22, in unsuccessful group 9.30±1.54, duration of mechanical ventilation (hour) in successful group was 82.54±72.31, in unsuccessful group 89.74±82.30, IWI in successful group was 42.30±12.16, in unsuccessful group 28.24±10.70. In IWI method among 62 patients studied, 58 were successful and 4 unsuccessful. APACHE II in successful group was 13.47±4.97, in unsuccessful group 13.25±4.57, Carrico index (PaO2/FiO2) in successful group was 212.80±42.15, in unsuccessful group 176.87±14.04, DO index(dissolved oxygen(SaO2)) in successful group was 95.30±3.12, in unsuccessful group 94.25±3.86, GCS Score in successful group was 9.03±1.75, in unsuccessful group 9.25±1.50, duration of mechanical ventilation (hr) in successful group was 141.43± 63.48, in unsuccessful group 51±15.10, IWI in successful group was 65.77±26.28, in unsuccessful group 40.15± 8.13. According to the research findings and studies that examined the predictive indexes of weaning from mechanical ventilation, it is indicated that in addition to objective and subjective criteria to determine the optimal time for successful weaning, predictive indexes should be used. The use of IWI index that integrates important weaning parameters can evaluate the weaning outcome with better accuracy.

Weaning from mechanical ventilation is one of the main stages of treatment as well as applying a tool that can predict the success in weaning is very important. This study aimed to evaluate the success rate of weaning from ventilator in patients admitted at the Intensive Care Unit (ICU) using Burn’s Wean Assessment Program (BWAP) checklist.
The present analytical cross-sectional study was carried out on 100 mechanical ventilation-dependent patients connected to the ventilator for more than 72 hours. All patients were selected by simple available sampling based on purposive sampling method and examined by BWAP checklist and were weaned from ventilator by obtaining scores over 18.
The total number of patients participating in the study was 100, 71 males and 29 females. There was no significant relationship between gender and success or failure of weaning process based on chi-square test (p Investigating preparation for weaning using Burn’s Scale is more useful for patients who had no prolonged hospitalization at ICU and ventilated through an endotracheal tube.

Weaning decision for the patients undergoing mechanical ventilation (MV) is often made based on personal judgments and experiences, which results in longer MV length of stay and higher costs. Therefore, the present study aimed to evaluate the effect of Burn’s wean assessment program on the success rate of weaning from ventilator in patients admitted to the Intensive care unit (ICU).
The present experimental study was carried out on 100 patients undergoing MV for more than 72 hours. The patients were selected by convenience sampling and randomly divided into two groups of 50 subjects. Burn’s wean assessment program was applied to the intervention group, while weaning was assessed by a physician in the control group.
35 patients in the intervention group were male and 15 were female. In the control group, 36 were male and 14 were female. Chi-square test showed no statistically significant difference between the two groups (P Using Burn’s scale for assessing patient readiness for weaning from mechanical ventilation is more useful.