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Implementacao, avaliacao e comparacao dos protocolos de desmame com tubo-T e pressao suporte associada a pressao expiratoria final positiva em pacientes submetidos a ventilacao mecanica por mais de 48 horas em unidade de terapia intensiva (Implementation, assessment and comparison of the T-tube and pressure-support weaning protocols applied to the intensive care unit patients who had received mechanical ventilation for more than 48 hours) [Portuguese]
Colombo T, Boldrini AF, Juliano SRR, Juliano MCR, Houly JGS, Gebara OCF, Cividanes GVL, Catao EC
Revista Brasileira de Terapia Intensiva 2007 Jan-Mar;19(1):31-37
clinical trial
2/10 [Eligibility criteria: Yes; Random allocation: No; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND AND OBJECTIVES: Mechanical ventilation incurs significant morbidity and mortality, weaning intensive care unit patients is highly desirable, although it is usually conducted in an empirical manner. Thus, this article assessed a weaning protocol implementation and compared two different methods. METHODS: It was carried out a study involving 120 patients who had received mechanical ventilation for more than 48 hours. These patients were randomly assigned to undergo one of two weaning techniques: pressure-support ventilation plus PEEP (PSP) technique, which was applied to the patients in equal days, forming the PSP group (PSPG) and the T-tube method (TT), applied in odd days and forming the TT group (TTG). Standardized protocols were followed for each technique. RESULTS: The patients response to extubation revealed similar progress in both PSP and TT groups, but after the Chi-square statistical test, the benefits of using a weaning protocol was clear. One hundred nine (90.83%) of all patients, had a successful weaning and any noninvasive ventilation type was needed in a span time of 24 hours after extubation, and only eleven (9.17%), had an unsuccessful weaning. CONCLUSIONS: Although this study didn't show any difference between the two methods applied, we could conclude that, the implementation of standardized weaning protocols can substantially decrease the patient's reintubation rate, promoting a downward trend in mortality and morbidity for these patients and shortening their hospital and intensive care units length of stay.

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