ArticleJournal of intensive care2019
A comprehensive protocol for ventilator weaning and extubation: a prospective observational study.
Article in Journal of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Ventilation-Weaning Protocols in Children Admitted to Pediatric Intensive Care Units: Systematic Review of Randomized Trials.Pediatric pulmonology · 2025Pooled it
- Article
- Machine learning-driven prediction model for successful weaning of patients from mechanical ventilation in ICU.Intensive care medicine experimental · 2026Article
- Article
- Influence of clinical severity and ventilation time on the use of timed inspiratory effort (TIE) as a predictor of success in ventilatory weaning.Journal of thoracic disease · 2025Article
- Liberation from mechanical ventilation using Extubation Advisor Decision Support (LEADS): protocol for a multicentre pilot trial.BMJ open · 2025Article
- Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis.BMC cardiovascular disorders · 2025Article
- Capturing Requirements for a Data Annotation Tool for Intensive Care: Experimental User-Centered Design Study.JMIR human factors · 2025Article
- The association of ventilator mechanical power with weaning outcomes in intensive care unit patients: a narrative review.Journal of thoracic disease · 2025Review
- Article
- Impact of delay extubation on the reintubation rate in patients after cervical spine surgery: a retrospective cohort study.Journal of orthopaedic surgery and research · 2023Review
- Developing a machine-learning model for real-time prediction of successful extubation in mechanically ventilated patients using time-series ventilator-derived parameters.Frontiers in medicine · 2023Article
- Diaphragmatic Rapid Shallow Breathing Index: A Simple Tool to Give more Power to Predict Weaning?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- The Contribution of Chest X-Ray to Predict Extubation Failure in Mechanically Ventilated Patients Using Machine Learning-Based Algorithms.Critical care explorations · 2022Article
- Positive Airway Pressure at Extubation Minimizes Subglottic Secretion Leak In Vitro.Journal of clinical medicine · 2022Article
- Observational
- New integrated weaning indices from mechanical ventilation: A derivation-validation observational multicenter study.Frontiers in medicine · 2022Article
- Ultrasound Assessment in Cardiogenic Shock Weaning: A Review of the State of the Art.Journal of clinical medicine · 2021Review
- Evaluation of the Perceived Barriers and Facilitators to Timely Extubation of Critically Ill Adults: An Interprofessional Survey.Worldviews on evidence-based nursing · 2021Article
- Two mechanically ventilated cases of COVID-19 successfully managed with a sequential ventilation weaning protocol: Two case reports.World journal of clinical cases · 2020Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVentilator weaning protocols have been shown to reduce the duration of mechanical ventilation (MV), intensive care unit length of stay, and resource use. However, weaning protocols have not significantly affected mortality or reintubation rates. The extubation process is a critical component of respiratory care in patients who receive MV. Post-extubation respiratory failure (PERF) is a common event associated with significant morbidity and mortality. We hypothesized that a comprehensive protocol for ventilator weaning and extubation would be effective for preventing PERF and reintubation and reducing mortality in critically ill patients.
methodsA ventilator weaning and extubation protocol was developed. The protocol consisted of checklists across four evaluations: spontaneous breathing trial, extubation, prophylactic non-invasive positive pressure ventilation (NPPV), and evaluation after extubation. Observational data were collected after implementing the protocol in patients admitted to the Advanced Emergency and Critical Care Center of Shinshu University Hospital. Not only outcomes of patients but also influences of each component of the protocol on the clinical decision-making process were investigated. Further, a comparison between PERF and non-PERF patients was performed.
resultsA total of 464 consecutive patients received MV for more than 48 h, and 248 (77 women; mean age, 65 ± 17 years) were deemed eligible. The overall PERF and reintubation rates were 9.7% and 5.2%, respectively. Overall, 54.1% of patients with PERF received reintubation. Hospital stay and mortality were not significantly different between PERF and non-PERF patients (
conclusionsWe found that the rates of PERF, reintubation, and hospital mortality were lower than those in previous reports even with nearly the same degree of severity at extubation. The comprehensive protocol for ventilator weaning and extubation may prevent PERF and reintubation and reduce mortality in critically ill patients.
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