Ventilatory weaning practices in intensive care units in the city of Cali.

OBJECTIVE: Early weaning from mechanical ventilation is one of the primary goals in managing critically ill patients. There are various techniques and measurement parameters for such weaning. The objective of this study was to describe the practices of ventilatory weaning in adult intensive care units in the city of Cali. METHODS: A survey of 32 questions (some multiple choice) evaluating weaning practices was distributed to physiotherapists and respiratory therapists working in intensive care units, to be answered anonymously. RESULTS: The most common strategy for the parameter set was the combination of continuous positive airway pressure with pressure support (78%), with a large variability in pressure levels, the most common range being 6 to 8 cm H2O. The most common weaning parameters were as follows: tidal volume (92.6%), respiratory rate (93.3%) and oxygen saturation (90.4%). The most common waiting time for registration of the parameters was >15 minutes (40%). The measurements were preferably obtained from the ventilator display. CONCLUSION: The methods and measurement parameters of ventilatory weaning vary greatly. The most commonly used method was continuous positive airway pressure with more pressure support and the most commonly used weaning parameters were the measured tidal volume and respiratory rate.

Prácticas de destete ventilatorio en las unidades de cuidado intensivo de la ciudad de Cali / Ventilatory weaning practices in intensive care units in the city of Cali

Objetivo: El destete temprano de la ventilación mecánica es uno de los objetivos primordiales en el manejo del paciente crítico. Existen diversas técnicas y parámetros de medida para realizarlo. El objetivo de esta investigación fue describir las prácticas del destete ventilatorio en unidades de cuidado intensivo adulto en la ciudad de Cali. Métodos: Una encuesta de 32 preguntas; algunas de múltiple escogencia, que evaluaron las prácticas del destete, fue distribuida entre los fisioterapeutas y terapeutas respiratorios que trabajaban en unidades de cuidado intensivo, para ser respondida de forma anónima. Resultados: La estrategia más frecuente para el registro de parámetros fue la combinación de presión positiva continua con presión de soporte (78%), con gran variabilidad en los niveles de presión, siendo el rango más frecuente de 6 a 8cmH2O. Los parámetros de destete más registrados fueron: el volumen corriente (92,6%), la frecuencia respiratoria (93,3%) y la saturación de oxígeno (90,4%). El tiempo de espera más frecuente para el registro de los parámetros fue >15 minutos (40%). Las medidas se realizaron preferentemente con el display del ventilador. Conclusion: Existe una gran variabilidad sobre los métodos y la medición de los parámetros de destete ventilatorio. El método más utilizado fue presión positiva continua en la vía aérea más presión de soporte y los parámetros de destete más usados fueron la medición del volumen corriente y la frecuencia respiratoria. .

Objective: Early weaning from mechanical ventilation is one of the primary goals in managing critically ill patients. There are various techniques and measurement parameters for such weaning. The objective of this study was to describe the practices of ventilatory weaning in adult intensive care units in the city of Cali. Methods: A survey of 32 questions (some multiple choice) evaluating weaning practices was distributed to physiotherapists and respiratory therapists working in intensive care units, to be answered anonymously. Results: The most common strategy for the parameter set was the combination of continuous positive airway pressure with pressure support (78%), with a large variability in pressure levels, the most common range being 6 to 8cmH2O. The most common weaning parameters were as follows: tidal volume (92.6%), respiratory rate (93.3%) and oxygen saturation (90.4%). The most common waiting time for registration of the parameters was >15 minutes (40%). The measurements were preferably obtained from the ventilator display. Conclusion: The methods and measurement parameters of ventilatory weaning vary greatly. The most commonly used method was continuous positive airway pressure with more pressure support and the most commonly used weaning parameters were the measured tidal volume and respiratory rate. .