ArticleAnnals of intensive care2018
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.
Article in Annals of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Expert consensus-based clinical practice guidelines for Care and weaning procedures in tracheostomized ICU patients after invasive mechanical ventilation: a joint statement by the Intensive Care Physiotherapy Society (SKR) and the French Intensive Care Society (SRLF).Annals of intensive care · 2026Article
- Effectiveness of a pedagogical module for the process of weaning from mechanical ventilation in advanced nursing education.PloS one · 2026Article
- Enhancing nurses' competence in mechanical ventilation: a quasi-experimental study and its association with patient severity using APACHE II.Frontiers in medicine · 2026Article
- Nurse-led evidence-based protocolized weaning for invasive mechanical ventilation patients in the ICU: a hybrid type 1 effectiveness-implementation study.BMC pulmonary medicine · 2025Article
- Thoracic trauma WSES-AAST guidelines.World journal of emergency surgery : WJES · 2025Review
- Management of tracheostomies in the intensive care unit: a scoping review.BMJ open respiratory research · 2020Article
- ICU staffing feature phenotypes and their relationship with patients' outcomes: an unsupervised machine learning analysis.Intensive care medicine · 2019Article
- Clinical Application of Modified Burns Wean Assessment Program Scores at First Spontaneous Breathing Trial in Weaning Patients from Mechanical Ventilation.Acute and critical care · 2018Article
- Protocolized ventilator weaning verses usual care: A randomized controlled trial.International journal of critical illness and injury scienceArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWeaning 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.
resultsWe 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.
conclusionsIn 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.
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