The Outcomes of ventilator weaning process for adult patient in intensive care department in Hebron government hospital رسالة ماجستير

Abstract

Background: the weaning outcome relates to patients who previously required a mechanical ventilator discontinuing or decreasing their dependency on it. In order to help the patient breathe on their own, the level of ventilator support provided by the ventilator is gradually reduced. Despite playing an essential role in saving lives, it has a number of problems ranging from minor to severe. Therefore, it's critical to lessen the hazards involved and patients' reliance on this technology in order to protect their wellbeing. Aim: to identify the extent to which a patient connected to a ventilator responds to the weaning process followed in the intensive care department. Methods: this retrospective study included 230 critically sick patients who were mechanically ventilated as a sample. The Hebron government hospital was the site of the study. The ICU housed all patients who were intubated and hospitalized between 1/1/ 2022 to 1/6/ 2023 (17 months). who had gone through the weaning process in accordance with accepted practice. Results: a 230 critically sick ICU patients, 60.9% of whom were men and 39.1% of whom were women. Over two thirds of the sample's participants were 60 years of age or older. Only 10.9% of patients on mechanical ventilation possessed Covid 19. As XIII contrast to surgical case diagnosis, medical diagnosis was used in the majority of instances (85.2%). According to gasometry results, more than half of the sample had respiratory alkalosis, 75% had metabolic acidosis, and 42% had low PH. Age and length of intubation were significantly different, as were medical diagnosis and weaning outcome/risk of negative outcomes, SOFA Score and APACHE Score/Predicted Mortality Rate , and weaning outcome/risk of adverse events. Infection with Covid--19 and ICU mortality rate, as well as antibiotics for respiratory failure and risk of adverse events, were not shown to be significantly correlated. Along with the use of sedation, there was a statistically significant difference between the duration of intubation and the success of weaning, as well as between the two. However, there was no evidence of a correlation between the usage of vasopressors/GCS score and the length of the intubation, its causes, or the length of weaning. Therefore, the length of the intubation was related to the length of weaning. The entire length of ventilation, meanwhile, was connected to both the overall length of ICU stay and hospitalization. Conclusion: Based on the study's findings, we advise taking medical diagnosis into account when evaluating the success of weaning and risk of negative outcomes. To reduce the need for intubation, individuals who have suffered cardiac arrest require quick intervention and specialist treatment. Scores from SOFA and APACHE can be used separately to forecast ICU mortality. It's critical to keep intubations brief to lower the likelihood of unfavorable outcomes. Given its effect on the length of the intubation and the success of the weaning process, sedation should be administered with caution. It is not advised to regularly take antibiotics for respiratory infections unless clinically necessary. The duration of intubation does not appear to be impacted by vasopressor usage. Weaning protocols should be created and implemented specifically for each XIV patient, taking into account their needs and medical issues. Clear criteria for assessment, monitoring, and decision--making during the weaning process should be included in these procedures. To find and fix any problems, healthcare personnel should give daily evaluations of ventilator settings, alarms, and equipment integrity first priority. The likelihood of difficulties can be reduced by taking care of these issues, which will result in more successful weaning outcomes.