Similarly, the implementation of a protocol for ventilator weaning may be useful to prevent VAP, as a result of the reduction in unneeded days on the ventilator and need for reintubation [ 8].
Process improvements included: 2008: tracheal suction protocol, prevention of colonization of ventilator tubing, HME change, oral care with hexetidin, cuff pressure control, 30° head elevation, ETT fixation, gastric residue control, ETT with polyurethane cuff, closed airway suctioning.
Moreover, the marked heterogeneity of ventilator protocols among these three studies (with resulting considerable differences in plateau pressures between one study [54] and the others [2, 53]) casts some doubt on the physiological rationale for this meta-analysis.
It would be most unfortunate if nurses were to become distracted from these vital and unique skills by diverting their attention to tasks of no benefit, such as the use of ventilator protocols.
Moreover, the marked heterogeneity of ventilator protocols among these three studies (with resulting considerable differences in plateau pressures between one study [ 54] and the others [ 2, 53]) casts some doubt on the physiological rationale for this meta-analysis.
Total ventilator and ICU days on and off protocol are reported in Table 3. Application of the triage protocol would potentially decrease the number of ventilator days required by 49.3% (568 days) and a decrease of 52.6% (895 days) in the total ICU days.
To ensure that the two groups of patients received the same kind of ventilator management a protocol was used (which can be obtained from the authors on request).
When looking at the decrease in resource utilization, they determined that application of the triage protocol would have reduced the number of ventilator days by 49.3% and the number of ICU days by 52.6%.
Marelich and colleagues [ 95] evaluated the effect of a single ventilator weaning protocol used in medical and surgical ICUs on the duration of mechanical ventilation and the incidence of ventilator associated pneumonia.
In the VS protocol, the ventilator automatically adjusted the level of PS to achieve an exhaled tidal volume of 5 to 7 ml/kg.
