| Title |
Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients: a pilot randomized controlled clinical trial
|
|---|---|
| Published in |
Annals of Intensive Care, January 2018
|
| DOI | 10.1186/s13613-018-0354-1 |
| Pubmed ID | |
| Authors |
Nazzareno Fagoni, Simone Piva, Elena Peli, Fabio Turla, Elisabetta Pecci, Livio Gualdoni, Bertilla Fiorese, Frank Rasulo, Nicola Latronico |
| Abstract |
Weaning protocols expedite extubation in mechanically ventilated patients, yet the literature investigating the application in tracheostomized patients remains scarce. The primary objective of this parallel randomized controlled pilot trial (RCT) was to assess the feasibility and safety of a nurse-led weaning protocol (protocol) compared to weaning based on physician's clinical judgment (control) in tracheostomized critically ill patients. We enrolled 65 patients, 27 were in the protocol group and 38 in the control group. Of 27 patients in the protocol group, 1 (3.7%) died in the ICU, 24 (88.9%) were successfully weaned from tracheostomy, and 2 (7.4%) were transferred still on the ventilator. Of 38 patients in the control group, 2 (5.3%) died in the ICU, 22 (57.9%) were successfully weaned from tracheostomy, and 14 were transferred still on the ventilator (36.8%). Risk of being discharged from the ICU on the ventilator was higher in the control group (relative risk: 1.5, IC 95% 1.14-2.01). Concerning safety and feasibility, no patients were excluded after randomization. There was no crossover between the two study arms nor missing data, and no severe adverse event related to the study protocol application was recorded by the staff. Weaning time and rate of successful weaning were not different in the protocol group compared to the control group (long-rank test, p = 0.31 for MV duration, p = 0.45 for weaning time). Based on our results and assuming a 30% reduction of the weaning time for the protocol group, 280 patients would be needed for a RCT to establish efficacy. In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. |
X Demographics
The data shown below were collected from the profiles of 67 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 14 | 21% |
| Spain | 11 | 16% |
| United States | 4 | 6% |
| Venezuela, Bolivarian Republic of | 2 | 3% |
| Italy | 2 | 3% |
| Australia | 2 | 3% |
| Sweden | 1 | 1% |
| Guernsey | 1 | 1% |
| Chile | 1 | 1% |
| Other | 1 | 1% |
| Unknown | 28 | 42% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 43 | 64% |
| Practitioners (doctors, other healthcare professionals) | 18 | 27% |
| Scientists | 4 | 6% |
| Science communicators (journalists, bloggers, editors) | 2 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 70 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 13 | 19% |
| Student > Bachelor | 7 | 10% |
| Student > Doctoral Student | 6 | 9% |
| Researcher | 5 | 7% |
| Professor | 4 | 6% |
| Other | 14 | 20% |
| Unknown | 21 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 20 | 29% |
| Medicine and Dentistry | 17 | 24% |
| Engineering | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Unspecified | 1 | 1% |
| Other | 6 | 9% |
| Unknown | 22 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 48. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 March 2019.
All research outputs
#810,226
of 24,151,461 outputs
Outputs from Annals of Intensive Care
#88
of 1,107 outputs
Outputs of similar age
#20,067
of 448,653 outputs
Outputs of similar age from Annals of Intensive Care
#2
of 33 outputs
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