The Science Journal of the American Association for Respiratory Care
BACKGROUND: To determine the rate of successful outcomes of a long-term ventilator-weaning program using a multi-discipline approach and the Siemens Servo 300 ventilator. METHOD: 150 patients who were transferred from acute care facilities for placement in a long term ventilator weaning program were followed for a 365 day period at the Drake Center, a long term Rehabilitation and Restorative Care center. A retrospective chart audit was performed to determine the utilization of weaning mode (i.e., SIMV vs. Volume Support) and the associated outcomes as it related to overall success, gender and average length of stay.
Results: Of the 150 patients followed, 13 were omitted due to a neuromuscular dysfunction, while 5 patients received ?No Trial? resulting from the gravity of their medical condition. They consequently were identified as a separate sub-group. Of the 137 patients remaining in the study, 8.8% were weaned via SIMV; 87.5% via Volume Support and 3.7% received no trial. Successful weaning outcomes were reported at various cutoff values: Day 1 (all patient inclusive) = 74.01%; Day 5 = 73.95%; Day 10 = 73.19% and Day 14 = 69.23%. The average length of stay by gender revealed females at 34.1 days with males at 37.6 days. The length of stay by success/failure is 30.2 days and 45.9 days respectively, with overall length of stay at 36.0 days. CONCLUSION: Utilization of a multi-disciplined approach in conjunction with weaning via the Volume Support mode of the Siemens Servo 300 appears to be an effective regimen in the treatment of the difficult to wean ventilator dependent patient.