J Korean Crit Care Nurs.  2024 Jun;17(2):42-54. 10.34250/jkccn.2024.17.2.42.

Results of Applying a Ventilator Weaning Protocol Led by an Advanced Practice Nurse for Cardiac Surgery Patients

• Eim Y
• Choi SJ

• KMID: 2556817
• DOI: http://doi.org/10.34250/jkccn.2024.17.2.42

Abstract

Purpose
: This study aimed to assess the effectiveness of an advanced practice nurse (APN)-driven ventilator weaning protocol for patients undergoing cardiac surgeries.
Methods
: A retrospective analysis was conducted on 226 patients admitted to the intensive care unit (ICU) of a tertiary hospital between January and June 2020, following a cardiac surgery. Patients were divided into an APN protocol-applied group (experimental group, n=152) and a control group managed based on doctors' judgment (n=74). Ventilator weaning criteria and clinical outcomes, including duration of ventilation, length of ICU stay, and rate of reintubation, were compared between the two groups.
Results
: Patients in the control group were older and had a higher incidence of massive bleeding from chest tube drainage (＞100 cc/hr) at baseline. The average duration of ventilation was significantly shorter in the experimental group compared to the control group (7.44 vs. 21.61 hours, p ＜.001). Furthermore, the mean length of ICU stay was shorter in the experimental group compared to the control group (47.96 vs. 77.97 hours, p ＜.001). There was no difference in the rate of reintubation between the two groups.
Conclusion
: These findings suggest that an APN-driven ventilator weaning protocol can improve clinical outcomes without significant complications. These results support the adoption of APN-driven mechanical ventilator weaning protocols in clinical practice.

Keyword

Cardiac surgical procedures, Advanced practice nursing, Mechanical ventilators, Ventilator weaning; 심장수술, 전문간호, 인공호흡기, 인공호흡 이탈