Multidisciplinary Weaning Protocol for Prevention of Extubation Failure in Lerdsin Hospital
Keywords:
Weaning protocol, Extubation failure, Survival, Mortality risk factorsAbstract
Background: Weaning protocol by doctors is widely used in general hospitals. However, there are extubation events still occur. Therefore, we generated the multidisciplinary weaning protocol (MDP) which focused on patient pathophysiology assessed by doctor and holistic care by medical term including nurse and physiologist, to study for improve successful extubation, reduce reintubation rate and mortality. Objectives: The primary objective is the effectiveness of the MDP for successful extubation, risk factors for reintubation, survival at 90 days and risk factors for mortality. Methods: We retrospectively studied intubated patients with mechanical ventilator whom admitted to Lerdsin Hospital from January 1, 2022 to December 31, 2022 and using MDP. Statistical significance was used at p < .05 and risk ratio with 95% confidential interval Result: A total of 147 intubated patients, average age of 62 years, 96 males and 51 females. There were 143 patients had been successfully extubation (97.3%). Univariate regression analysis showed no significant risk factor affect successful extubation. Survival rate at 90 days was 88.4%. Multivariate regression analysis including age > 60 year-old, intubation period >7 days, PaO2/FiO2 < 150, PaCO2 > 45 mmHg and pH < 7.35 showed sepsis and PaO2/FiO2 < 150 increase risk for death (OR 6.3, P = .01 and OR 3.58, P = .035 respectively). Conclusion: The use of the MDP has high successful extubation rate and survival at 90 days without significant risk factor which affect successful extubation
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