• Claire J Black, Martin Kuper, Geoff J Bellingan, Steve Batson, Claire Matejowsky, and David C J Howell.
• UCL Hospitals NHS Foundation Trust, London NW1 2BU, UK. claire.black@uclh.nhs.uk
• Brit J Hosp Med. 2012 Aug 1; 73 (8): 462-6.

ObjectiveTo establish whether multidisciplinary team-led strategies to maintain continuity across the weaning process result in an increase in the proportion of patients surviving prolonged mechanical ventilation and reduce the length of time patients are ventilated.DesignA quality improvement programme was conceived and implemented for patients receiving mechanical ventilation for >21 days.SettingUniversity teaching hospital general intensive care unit.InterventionsThe introduction of long-term weaning plans.Measurements And Main ResultsIntensive care unit survival odds ratio and 95% confidence interval. 0.181 (0.06-0.49) P<0.01 and hospital survival odds ratio and 95% confidence interval 0.2 (0.08-0.61) P<0.01, Duration of mechanical ventilation (median 95@ confidence interval ) 53 days (32-37) vs 43 days (39-44) P=0.03.ConclusionLong-term weaning plans led by a multidisciplinary, team were associated with a reduction in intensive care unit and hospital mortality, and duration of mechanical ventilation in patients ventilated for ≥ 21 days. Strategies to maintain continuity in this patient parent group are likely fundamental to improving outcome.

26 keywords...

hide…