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Weaning Protocol (weaning + protocol)

Distribution by Scientific Domains
Medical Sciences75%

Selected Abstracts

To Explant or Not to Explant: An Invasive and Noninvasive Monitoring Protocol to Determine the Need of Continued Ventricular Assist Device Support

CONGESTIVE HEART FAILURE, Issue 2 2009
Satoru Osaki MD
Predictors of myocardial recovery after ventricular assist device (VAD) implantation are not well defined. The authors report their current VAD weaning protocol. Between 2003 and 2006, 38 patients received VAD implants. The authors performed 5 tests in 4 patients in whom echocardiography findings suggested myocardial recovery after implant. The protocol consists of assessing symptoms, electrocardiographic findings, hemodynamics, and cardiac function at baseline and as VAD support is weaned. As a result, 3 patients passed the weaning protocol and were explanted. There has been no recurrence of heart failure 667, 752, and 1007 days after explant, respectively. One patient failed the protocol after 151 days of support because of low cardiac index during the protocol. This patient was transplanted. This current experience of VAD weaning protocol is a novel tool to identify candidates for successful VAD explantation. [source]

Observing the approaches to weaning of the long-term ventilated patients

NURSING IN CRITICAL CARE, Issue 2 2010
Kalliopi Kydonaki
Background: The weaning process from mechanical ventilation is a complicated issue for patients with respiratory failure who require long-term respiratory support. Although the application of weaning protocols reduces weaning time, and enhances patient outcome, little is known about the actual approaches that clinicians use for the weaning of these patients. Aim: The purpose of this paper is to explore approaches to weaning of long-term ventilated patients in a Scottish Intensive Care Unit. The findings are part of a larger study on decision-making during the weaning of long-term ventilated patients. Method: Data were collected through participant observation and follow-up interviews with the nursing staff. Twenty-four-hour chart and medical notes review and informal conversation with the bedside nurse were also used to collect information on the weaning process. Findings: Nine patients were recruited to the study. Two patients were extubated and three patients were extubated but then required a tracheostomy. A further four patients had a tracheostomy performed. Thematic analysis of the data showed that weaning was individualized, and physician led, regardless of the existence of the weaning protocol. Six different weaning approaches were identified. Nurses followed a conservative approach to weaning in comparison to doctors who appeared more aggressive. Conclusion: There are many varieties in the approaches clinicians use when weaning long-term ventilated patients, which acts on the continuity of their care. A shift of focus to identify ways of maintaining continuity of care and a combined ,wake and wean' approach needs to be considered. [source]

An evaluation of the impact of a tracheostomy weaning protocol on extubation time

NURSING IN CRITICAL CARE, Issue 5 2009
Alison Spencer
[source]

Advances in rearing techniques of Pagrus pagrus, (Linnaeus, 1758): comparison between intensive and semi-intensive larval rearing systems

AQUACULTURE RESEARCH, Issue 3 2010
Francisco Javier Roo
Abstract Red porgy, Pagrus pagrus L., is a potential candidate for marine finfish diversification on commercial Mediterranean and Atlantic coastal aquaculture. This paper described the development of a suitable larval rearing protocol for commercial application. Red porgy eggs were reared under Intensive and Semi-intensive systems until 50 days after hatching. In addition, two different weaning protocols were tested for each rearing system. The effects of these treatments were evaluated on the growth, survival and whole-body biochemical and fatty acid composition of red porgy larvae. Significant differences in growth but not in survival at 50 days after hatching were detected in trial A for the semi-intensive and intensive rearing system (23.5 ± 2.7,18.9 ± 3.4 mm; 4.4,4.9%); however, modifications in initial prey density and illumination conditions, implemented in trials B (29.5 ± 3.0,25.2 ± 1.9 mm; 21.8,5.3%) and C (26.2 ± 2.6,24.6 ± 2.6 mm; 22.7,3.8%), significantly improved survival and growth rates in the semi-intensive rearing system. Furthermore, the results in trial C confirmed the feasibility of a partial reduction in Artemia use and the significant improvement in survival rates with the new weaning protocol applied (26.4 ± 2.3,24.1 ± 3.9 mm; 28.7,12.5%) in the intensive systems. The results of this study concluded that the best larval rearing protocol for commercial production of red porgy fingerlings should include the use of semi-intensive systems. [source]

Physicians' perceptions of protocol-directed weaning in an intensive care unit in Norway

NURSING & HEALTH SCIENCES, Issue 1 2009
Britt Sætre Hansen ccrn, mnsc
Abstract The aim of this paper is to identify physicians' perceptions of protocol-directed weaning from mechanical ventilation in an intensive care unit in Norway. Errors occur in the absence of procedures, plans, and a team culture. Standardized weaning protocols, or pathways, offer a systematic approach. The focus group method was used. Four themes emerged: (i) acceptance, where the participants perceived the protocol as having a positive influence on the weaning process, although some barriers were identified, such as its failure to facilitate the "difficult-to-wean" patient; (ii) indignant responses, which gave the impression that the protocol was prescribed for the benefit of the nurses; (iii) ambivalence was evident in the two different approaches to the weaning process when problems occurred, which were "directing" and "collaborating"; and (iv) continuity and professional competence were perceived as important aspects of the weaning process. An unclear pattern of responsibility and poor interprofessional collaboration and communication were reported. [source]

Observing the approaches to weaning of the long-term ventilated patients

NURSING IN CRITICAL CARE, Issue 2 2010
Kalliopi Kydonaki
Background: The weaning process from mechanical ventilation is a complicated issue for patients with respiratory failure who require long-term respiratory support. Although the application of weaning protocols reduces weaning time, and enhances patient outcome, little is known about the actual approaches that clinicians use for the weaning of these patients. Aim: The purpose of this paper is to explore approaches to weaning of long-term ventilated patients in a Scottish Intensive Care Unit. The findings are part of a larger study on decision-making during the weaning of long-term ventilated patients. Method: Data were collected through participant observation and follow-up interviews with the nursing staff. Twenty-four-hour chart and medical notes review and informal conversation with the bedside nurse were also used to collect information on the weaning process. Findings: Nine patients were recruited to the study. Two patients were extubated and three patients were extubated but then required a tracheostomy. A further four patients had a tracheostomy performed. Thematic analysis of the data showed that weaning was individualized, and physician led, regardless of the existence of the weaning protocol. Six different weaning approaches were identified. Nurses followed a conservative approach to weaning in comparison to doctors who appeared more aggressive. Conclusion: There are many varieties in the approaches clinicians use when weaning long-term ventilated patients, which acts on the continuity of their care. A shift of focus to identify ways of maintaining continuity of care and a combined ,wake and wean' approach needs to be considered. [source]

Advances in rearing techniques of Pagrus pagrus, (Linnaeus, 1758): comparison between intensive and semi-intensive larval rearing systems

AQUACULTURE RESEARCH, Issue 3 2010
Francisco Javier Roo
Abstract Red porgy, Pagrus pagrus L., is a potential candidate for marine finfish diversification on commercial Mediterranean and Atlantic coastal aquaculture. This paper described the development of a suitable larval rearing protocol for commercial application. Red porgy eggs were reared under Intensive and Semi-intensive systems until 50 days after hatching. In addition, two different weaning protocols were tested for each rearing system. The effects of these treatments were evaluated on the growth, survival and whole-body biochemical and fatty acid composition of red porgy larvae. Significant differences in growth but not in survival at 50 days after hatching were detected in trial A for the semi-intensive and intensive rearing system (23.5 ± 2.7,18.9 ± 3.4 mm; 4.4,4.9%); however, modifications in initial prey density and illumination conditions, implemented in trials B (29.5 ± 3.0,25.2 ± 1.9 mm; 21.8,5.3%) and C (26.2 ± 2.6,24.6 ± 2.6 mm; 22.7,3.8%), significantly improved survival and growth rates in the semi-intensive rearing system. Furthermore, the results in trial C confirmed the feasibility of a partial reduction in Artemia use and the significant improvement in survival rates with the new weaning protocol applied (26.4 ± 2.3,24.1 ± 3.9 mm; 28.7,12.5%) in the intensive systems. The results of this study concluded that the best larval rearing protocol for commercial production of red porgy fingerlings should include the use of semi-intensive systems. [source]