Resp Care
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Randomized Controlled Trial Clinical Trial
Weaning children from mechanical ventilation: a prospective randomized trial of protocol-directed versus physician-directed weaning.
Compare outcomes between physician-directed and protocol-directed weaning from mechanical ventilation in pediatric patients. ⋯ Protocol-directed weaning resulted in a shorter weaning time than physician-directed weaning in these pediatric patients.
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Endotracheal suctioning of mechanically ventilated, very-low-birthweight infants for removal of respiratory secretions can be associated with morbidity. Routine endotracheal suctioning is inadvisable, but the safe minimum endotracheal suctioning frequency for prevention of airway obstruction has not been determined. ⋯ A low-frequency suctioning regimen (every 8 hours plus as needed) can be implemented without increasing the incidence of nosocomial BSI, VAP, bacterial airway colonization, frequency of reintubation, need for postural drainage, severity of BPD, neonatal mortality, duration of mechanical ventilation, or duration of hospitalization. Although the minimum suctioning frequency for removal of unwanted respiratory secretions is yet to be established, a substantial reduction in endotracheal suctioning frequency appears to be safe.