Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Protocol-directed weaning: a process of continuous performance improvem | Critical Care April 2005 Vol 9 No 2 Ramachandran et al. Commentary Protocol-directed weaning a process of continuous performance improvement Venkat Ramachandran1 Mary Jo Grap2 and Curtis N Sessler1 1The Department of Medicine Medical College of Virginia Campus of the Virginia Commonwealth University Richmond Virginia USA 2School of Nursing Medical College of Virginia Campus of the Virginia Commonwealth University Richmond Virginia USA Corresponding author Curtis N Sessler csessler@ Published online 28 January 2005 Critical Care 2005 9 138-140 DOI cc3053 This article is online at http content 9 2 138 2005 BioMed Central Ltd See related research by Tonnelier et al. in this issue http content 9 2 R83 Abstract The use of a nursing-directed and or respiratory therapist-directed protocol in many intensive care units for weaning from mechanical ventilation is associated with a shorter duration of ventilation and length of stay in the ICU. Most protocols have two formal components the daily screening of a set of simple observations or interventions to identify readiness to proceed followed by a spontaneous breathing trial that tests the patient s ability to breathe independently. The daily screen is designed to identify potential barriers regarding medical stability level of consciousness oxygenation ventilation and airway patency and protection. However one must avoid selecting criteria that are too restrictive potentially delaying the discontinuation of ventilation. In this issue of Critical Care Tonnelier and colleagues 1 report beneficial effects of a nurses protocol-directed weaning strategy to discontinue mechanical ventilation MV in patients requiring ventilatory support for greater than 48 hours. Whereas many controlled trials conducted in North America have demonstrated the effectiveness of nursingbased and respiratory therapist-based protocols in the early discontinuation of MV and reducing the length of stay in the .
