The Science Journal of the American Association for Respiratory Care

2000 OPEN FORUM Abstracts

An Interdisciplinary Protocol for Ventilator Weaning in Pediatric Cardiac Patients

Jenni L. Raake, BS, RRT, Susan Ryckman, RN, MSN, Karen Uzark, RN, PhD, PNP, Dawn Sweeney, MD, Peter Manning, MD, Jeffrey Pearl, MD, Steven M. Schwartz, MD, David P. Nelson, MD, PhD The Heart Center Children's Hospital Medical Center, Cincinnati, OH

Background: Patients undergoing cardiac surgery often require mechanical ventilation and intensive care during their postoperative course. Extended time on mechanical ventilation prolongs length of stay (LOS) in intensive care and the hospital. We developed an interdisciplinary program involving anesthesia, cardiology, cardiothoracic surgery, nursing, and respiratory care to decrease the need for mechanical ventilation, intensive care, and hospital care in postoperative pediatric cardiac patients. Methods: The ventilator weaning protocol was implemented for selected patients greater than three (3) months without evidence of lung disease or hemodynamic instability. Patients ranged between 4 months and 16.4 years of age. Retrospective review was performed for comparison with focus on total mechanical ventilation hours, CCU LOS, and hospital LOS. Results: Patients enrolled in the program experienced a reduction in MV hours, CCU LOS, and hospital LOS (see table).

Vent hours CCU days Hospital days n avg. age
Pre protocol 12.4 2.6 5.1 20 4.09 years
Post Protocol 8.9 1.7 3.75 20 6.59 years

Conclusions: Patients enrolled in a ventilator weaning protocol experienced a reduction in mechanical ventilation time without a need for reintubation, and a reduction in intensive care, and hospital care.

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