A randomized, controlled trial of protocol-directed versus physician- directed weaning from mechanical ventilation

Critical Care Medicine

Volumn 25, Issue 4, 1997, Pages 567-574

  Kollef, Marin H ^a   Shapiro, Steven D ^a   Silver, Patricia ^b   St John, Robert E ^b   Prentice, Donna ^b   Sauer, Sharon ^b   Ahrens, Tom S ^b   Shannon, William ^a   Baker Clinkscale, Darnetta ^b  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b BARNES JEWISH HOSPITAL   (United States)

Author keywords

critical care; intensive care unit; mechanical ventilation; nursing; outcomes; protocol directed therapy; respiratory therapy; weaning

Indexed keywords

ADULT; ADULT RESPIRATORY DISTRESS SYNDROME; AGED; ARTICLE; ARTIFICIAL VENTILATION; CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL PROTOCOL; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CRITICAL ILLNESS; FEMALE; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; LUNG EDEMA; MAJOR CLINICAL STUDY; MALE; NURSING; PHYSICIAN; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RESPIRATORY FAILURE; TREATMENT OUTCOME;

EID: 0030956523     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/00003246-199704000-00004     Document Type: Article

References (26)

1. American College of Chest Physicians Consensus Conference: Mechanical ventilation. Chest 1993; 104:1833-1859
2. Pierson DJ: Weaning from mechanical ventilation: Why all the confusion? Respir Care 1995; 40:228-232
3. Weinberger SE, Weiss JW: Weaning from ventilatory support. N Engl J Med 1995; 332:388-389
4. Marini JJ: Weaning from mechanical ventilation. N Engl J Med 1991; 324: 1496-1498
5. Brochard L, Rauss A, Benito S, et al: Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med 1994; 150:896-903
6. Esteban A, Frutos F, Tobin MJ, et al: A comparison of four methods of weaning patients from mechanical ventilation. N Engl J Med 1995; 332:345-350
7. Knaus WA, Draper EA, Wagner DP, et al: APACHE II: A severity of disease classification system. Crit Care Med 1985; 13:818-829
8. Kollef MH: Ventilator-associated pneumonia: A multivariate analysis. JAMA 1993; 270:1965-1970
9. Bernard GR, Artigas A, Brigham KL, et al: The American-European Consensus Conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994; 149:818-824
10. Kollef MH, Shapiro SD, Fraser VJ, et al: Mechanical ventilation with or without 7-day circuit changes: A randomized controlled trial. Ann Intern Med 1995; 123:168-174
11. Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. Journal of the American Statistical Association 1958; 53:457-481
12. SAS/STAT User's Guide. Vol 2. Cary, NC, SAS Institute, 1990, pp 1027-1069
13. Cox DR: Regression models and life-tables. Journal of the Royal Statistical Society [B] 1972; 34:187-220
14. Wood G, MacLeod B, Moffatt S: Weaning from mechanical ventilation: Physician-directed versus a respiratory-therapist-directed protocol. Respir Care 1995; 40:219-224
15. Anderson J, O'Brien M: Challenges for the future: The nurse's role in weaning patients from mechanical ventilation. Intensive and Critical Care Nursing 1995; 11:2-5
16. Cohen IL: Weaning from mechanical ventilation - The team approach and beyond. Intensive Care Med 1994; 20: 317-318
17. Carzoli RP, Martinez-Cruz M, Cuevas LL, et al: Comparisons of neonatal nurse practitioners, physician assistants, and residents in the neonatal intensive care unit. Arch Pediatr Adolesc Med 1994; 148:1271-1276
18. Rotello LC, Warren J, Jastremski MS, et al: A nurse-directed protocol using pulse oximetry to wean mechanically ventilated patients from toxic oxygen concentrations. Chest 1992; 102: 1833-1835
19. Holzman MD, Elkins CC, Neuzil DF, et al: Expanding the physician care team: Its effect on patient care, resident function, and education. J Surg Res 1994; 56:636-640
20. Clochesy JM, Daly BJ, Idemoto BK, et al: Preparing advanced practice nurses for acute care. Am J Crit Care 1994; 3: 255-259
21. Kollef MH, Bock KS, Richards R, et al: Safety and diagnostic accuracy of minibronchoalveolar lavage performed by respiratory therapists in patients with suspected ventilator-associated pneumonia. Direct comparison with the protected specimen brush. Ann Intern Med 1995; 122:743-748
22. Thorens J-B, Kaelin RM, Jolliet P, et al: Influence of the quality of nursing on the duration of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease. Crit Care Med 1995; 23:1807-1815
23. 2 removal for adult respiratory distress syndrome. Am J Respir Crit Care Med 1994; 149: 295-305
24. Tarlov AR, Ware JE Jr, Greenfield S, et al: The Medical Outcomes Study. An application of methods for monitoring the results of medical care. JAMA 1989; 262:925-930
25. Civetta J, Hudson-Civetta J: Maintaining quality of care while reducing charges in the intensive care unit. Ann Surg 1985; 202:524-532
26. Zapol WM: Iatrogenic complications in the intensive care unit. Crit Care Med 1993; 21:8-9