“STUDY OF METHODS ,CRITERIAAND OUTCOME OF WEANING FROM INVASIVE MECHANICAL VENTILATION IN INTENSIVE RESPIRATORY CARE UNIT”

Abstract

INTRODUCTION: The term "weaning" is used to describe the gradual process of decreasing ventilator support. Usually the criteria used are improvement of gas exchange, improvement of mental status, neuromuscular functional assessment and radiographic signs [2]. METHODOLOGY: In this Longitudinal study patients were recruited based on vitals, such as orientation(according to time, place and person), Respiratory Rate(>30/min), low saturation of oxygen, etc.. further follow up was done for criteria and methods of weaning over a period of 18 months and data analysis was conducted over the period of 6 months. RESULT: In our study The Mean ± SD age of the patients was 61.2±19.5 years (Range: 28- 88 years).25 (62.5%) were male and 15 (38.5%) were female. Most common diagnosis was COPD - 18 (45.0%) patients followed by bilateral pneumonia - 11 (27.5%) patients, ILD - 4 (10.0%), Koch's - 3 (7.5%) and 2 (5.0%) patients in each diagnosis of bronchial asthma and bronchiectasis. 11 (27.5%) patients had past history of ventilator support. There was no association between success of treatment and past history of ventilatory support. 23 (57.5%) patients had elective intubation whereas 17 (42.5%)patients had emergency intubation. spontaneous breathing (SBT) trial was successful in 24 (60.0%) patients. 25 (62.5%) patients were extubated and 15 (37.5%) patients were expired. CONCLUSION: Successful weaning from mechanical ventilation in the ICU depends on the application of skilled judgment, decision making, and medical and nursing interventions. On the other hand, overly aggressive and premature discontinuation of ventilatory support can precipitate ventilatory muscle fatigue, gas-exchange failure, and loss of airway protection.