Determining the best threshold of rapid shallow breathing index in a therapist-implemented patient-specific weaning protocol.

Background: For weaning patients from prolonged mechanical ventilation, we previously designed a respiratory-therapist-implemented weaning protocol that decreased median weaning time from 29 days to 17 days. An acceleration step at the start of the protocol allowed patients with a rapid shallow breathing index (RSBI) of < or = 80 to advance directly to spontaneous breathing trials (SBTs).

Methods: We prospectively evaluated whether calibrating the RSBI threshold allowed more patients to safely accelerate to the 1-hour SBT in the protocol, and whether that correlated with weaning duration and outcome.

Post-ICU mechanical ventilation at 23 long-term care hospitals: a multicenter outcomes study.

Study Objectives: This multicenter study was undertaken to characterize the population of ventilator-dependent patients admitted to long-term care hospitals (LTCHs) with weaning programs, and to report treatments, complications, weaning outcome, discharge disposition, and survival in these patients.

Design: Observational study with concurrent data collection.

Setting: Twenty-three LTCHs in the United States.

Ventilator-dependent survivors of catastrophic illness transferred to 23 long-term care hospitals for weaning from prolonged mechanical ventilation.

Study Objectives: This multicenter study was undertaken to characterize the population of ventilator-dependent patients admitted to long-term care hospitals (LTCHs) for weaning from mechanical ventilation.

Design: Observational study with concurrent data collection. Characteristics of the LTCHs were also surveyed.

Liberation from prolonged mechanical ventilation.

After weaning from PMV, patients are usually far from ready to resume normal activities. A prolonged recovery period after catastrophic illness is the rule, with multidisciplinary rehabilitation and discharge planning efforts. Following such efforts, reports of success of restorative care are institutional and population specific.