mechanical ventilator weaning
...cent blood gas analysis, positive end expiratory pressure (PEEP) of 7 cm H2o or lower, and fraction of inspired oxygen (Floz) of 0.6 or less” (Randolph,et al,pg.3). The extubation readiness test (ERT) consisted of changing the F2 to 0.5 and decreasing PEEP to 5cm H20. With both setting adjustments, the spo2 had to stay above 95%. This was measured using a pulse oximetry reading. The patients unable to maintain spo2 of 95% or greater were removed from the test. Those who did maintain spo2 at 95%v or above had their ventilator mode changed to PSV and were placed on minimal PSV. Exhaled tidal volumes were measured at the ETT using a CO2SMO Plus monitor with sensors. (Novametrix Medical Systems, Inc.) I think the measurements that were used in the study are reliable and effective. It is appropriate to monitor spo2 levels and exhaled tidal volumes when deciding to wean a vent. Patient. Measurement tools used to evaluate the research information included using The Fisher exact test to compare the proportion of weaning failures between groups. Logistic regression was used to assess the effects on weaning of sedation received during the first 24 hours. Weaning time analysis only used cases that were successfully extubated. The Kaplan-Meier survival curves and log-rank tests were used to compare the weaning times of the different groups. The results of this study really did not provide ample support for the effectiveness of ventilator weaning whether it is using a protocol or standard care. Basically, the study showed that no matter what method of weaning you use, the end results are very similar. The study revealed that there is no significant difference between weaning times for children receiving protocol-directed weaning (PSV and VSV) and traditional physician-directed weaning. The mean weaning times for the PSV, VSV and the no protocol groups were 3.3, 2.5, and 3.2 days. The recent research provides support for the effectiveness of the evidenced-based practice as far as when to start weaning patients. The research article emphasized that a lot of times when the doctor decides to start the weaning process, the patient has already been on the ventilator too long, and sometimes could ha...