Efeitos da aplicação de protocolo de desmame de ventilação mecânica em Unidade Coronária: Estudo randomizado

Abstract

Objective: To compare mechanical ventilation weaning based on a protocol using the spontaneous breathing trial against mechanical ventilation weaning without a standardized protocol in heart patients. Methods: Prospective, open, randomized study. In 2006, 36 patients undergoing mechanical ventilation for over 24 hours were randomized into two groups: control group - eighteen patients whose mechanical ventilation weaning was performed according to the different procedures adopted by the multidisciplinary team; and experimental group - eighteen patients weaned according to previously established protocol. Results: Control group patients started the weaning process sooner than experimental group patients (74.7 ± 14.7 hours vs. 185.7 ± 22.9 hours, P=0.0004). However, after the experimental group patients were ready for weaning, the extubation was carried out more rapidly than in the control group (149.1 ± 3.6 min vs. 4179.1 ± 927.8 min, P < 0.0001) with significantly lower reintubation rates (16.7% vs. 66.7%, P = 0.005). Conclusion: The use of a specific protocol based on the spontaneous breathing trial for mechanical ventilation weaning in heart patients had better outcomes than weaning carried out without a standardized protocol, with shorter weaning times and lower reintubation rates.