TY - JOUR
T1 - Weaning from Mechanical Ventilator in a Long-term Acute Care Hospital
T2 - A Retrospective Analysis
AU - Surani, Salim
AU - Sharma, Munish
AU - Middagh, Kevin
AU - Bernal, Hector
AU - Varon, Joseph
AU - Ratnani, Iqbal
AU - Anjum, Humayun
AU - Khan, Alamgir
N1 - Publisher Copyright:
© 2020 Surani et al.
PY - 2020
Y1 - 2020
N2 - Background: Prolonged Mechanical Ventilation (PMV) is associated with a higher cost of care and increased morbidity and mortality. Patients requiring PMV are referred mostly to Long-Term Acute Care (LTAC) facilities. Objective: To determine if protocol-driven weaning from mechanical ventilator by Respiratory Therapist (RT) would result in quicker weaning from mechanical ventilation, cost-effectiveness, and decreased mortality. Methods: A retrospective case-control study was conducted that utilized protocol-driven ventilator weaning by respiratory therapist (RT) as a part of the Respiratory Disease Certification Program (RDCP). Results: 51 patients on mechanical ventilation before initiation of protocol-based ventilator weaning formed the control group. 111 patients on mechanical ventilation after implementation of the protocol formed the study group. Time to wean from the mechanical ventilation before the implementation of protocol-driven weaning by RT was 16.76 +/-18.91 days, while that after the implementation of protocol was 7.67 +/-6.58 days (p < 0.0001). Mortality proportion in patients after implementation of protocol-based ventilator weaning was 0.21 as compared to 0.37 in the control group (p=0.0153). The daily cost of patient care for the LTAC while on mechanical ventilation was $2200/day per patient while it was $ 1400/day per patient while not on mechanical ventilation leading to significant cost savings. Conclusion: Protocol-driven liberation from mechanical ventilation in LTAC by RT can significantly decrease the duration of a mechanical ventilator, leading to decreased mortality and cost savings.
AB - Background: Prolonged Mechanical Ventilation (PMV) is associated with a higher cost of care and increased morbidity and mortality. Patients requiring PMV are referred mostly to Long-Term Acute Care (LTAC) facilities. Objective: To determine if protocol-driven weaning from mechanical ventilator by Respiratory Therapist (RT) would result in quicker weaning from mechanical ventilation, cost-effectiveness, and decreased mortality. Methods: A retrospective case-control study was conducted that utilized protocol-driven ventilator weaning by respiratory therapist (RT) as a part of the Respiratory Disease Certification Program (RDCP). Results: 51 patients on mechanical ventilation before initiation of protocol-based ventilator weaning formed the control group. 111 patients on mechanical ventilation after implementation of the protocol formed the study group. Time to wean from the mechanical ventilation before the implementation of protocol-driven weaning by RT was 16.76 +/-18.91 days, while that after the implementation of protocol was 7.67 +/-6.58 days (p < 0.0001). Mortality proportion in patients after implementation of protocol-based ventilator weaning was 0.21 as compared to 0.37 in the control group (p=0.0153). The daily cost of patient care for the LTAC while on mechanical ventilation was $2200/day per patient while it was $ 1400/day per patient while not on mechanical ventilation leading to significant cost savings. Conclusion: Protocol-driven liberation from mechanical ventilation in LTAC by RT can significantly decrease the duration of a mechanical ventilator, leading to decreased mortality and cost savings.
KW - Difficult weaning
KW - Liberation from mechanical ventilation
KW - Long term acute care
KW - Prolonged mechanical ventilation
KW - Respiratory therapist in weaning
KW - Ventilator weaning
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U2 - 10.2174/1874306402014010062
DO - 10.2174/1874306402014010062
M3 - Article
AN - SCOPUS:85130882253
SN - 1874-3064
VL - 14
SP - 62
EP - 66
JO - Open Respiratory Medicine Journal
JF - Open Respiratory Medicine Journal
IS - 1
ER -