PROTOCOLIZED VERSUS NON‐PROTOCOLIZED WEANING FOR REDUCING THE DURATION AND COMPLICATIONS OF INVASIVE MECHANICAL VENTILATION IN PREMATURE INFANTS
جامعة النجاح الوطنية
Background: For critically unwell newborns with respiratory failure admitted to a neonatal intensive care unit, mechanical ventilation is a life-saving operation (NICU). Due to small tidal volumes, high breathing frequencies, and the use of un-cuffed endotracheal tubes, ventilating newborns can be difficult. Weaning off the ventilator is initiated as soon as feasible to avoid difficulties. Aims: The aims of the study was to compare the effectiveness of protocolized versus non-protocolized ventilator weaning in reducing the duration of invasive mechanical ventilation, weaning time, and NICU and hospital length of stay for newborn infants. To see how effective, it is in specific subgroups, such as gestational age and birth weight. Material and methods: A quasi-experimental study conducted in patients undergoing protocolized versus non‐protocolized weaning from invasive mechanical ventilation in premature infants in neonatal intensive care unit. Experimental group (n=30) was infants undergoing a weaning protocol from mechanical ventilator at gestational age 26 week and above. Historical Control Group (n=30) includes patients who were on mechanical ventilation at gestational age 26 week and above, conducted between July 2019 and June 2020 at Holy Family Hospital. Bethlehem. Palestine. with the same, ICU staff. Results: The results show that the mean of weaning duration till extubation, length of stay in NICU and Hospital length of stay in the Historical group is significantly higher than that in the Protocol group. The results show that 7 cases of 30 had pulmonary interstitial emphysema in the Historical while no cases in the Protocol group. Also, there are 6 cases of 30 had ventilator-associated pneumonia (VAP) in the Historical group while no cases had ventilator-associated pneumonia (VAP) in the Protocol group. Conclusion: Weaning protocol reduces the duration of mechanical ventilation, weaning duration till extubation, NICU and hospital length of stay (days), the risk of weaning failure and reintubation. There is evidence to support the superiority of protocol weaning over nonprotocol weaning on the duration of invasive mechanical ventilation in newborn infants, according to the findings of this study.
Neonatal intensive care unit; Newborn; Mechanical Ventilation; Respiratory Failure