Dados do Trabalho

Título

Enhancing tracheostomy weaning duration in the ICU: impact of a comprehensive and multidisciplinary protocol

Objetivo

Efficient tracheostomy weaning is pivotal in improving outcomes for mechanically ventilated patients. This study focused on the integration of a protocol within a multidisciplinary ICU team aimed at reducing tracheostomy weaning.

Métodos

We conducted a retrospective study at a private hospital in the northeastern region of Brazil. We included patients who underwent tracheostomy during their ICU stay. The ICU multidisciplinary team underwent educational training in late 2018 for a novel tracheostomy weaning protocol. In November 2020, speech therapy services were integrated within the ICU rehabilitation team, providing 12 hours of coverage / day. An updated protocol was then established, including daily swallowing assessments. The protocol was again updated with additional goals in October 2021, such as achieving weaning within a maximum of 3 days.

Resultados

183 individuals were enrolled (69.44 ± 18.44 years; 38.79% were female). Repeated measures ANOVA revealed that the mean time for tracheostomy weaning significantly decreased across the studied years [F (3) = 12.47, p = 0.00, partial η2 = 0.61]. There was a constant trend towards a shorter duration of tracheostomy weaning from 2019 to 2022, with significantly lower mean times found in 2021 (3.00 ± 1.96 days; p = 0.02) and 2022 (2.25 ± 1.35 days; p = 0.03) when compared to 2019 (10.39 ± 5.74) when the protocol was first implemented.

Conclusão

The implementation of an integrated rehabilitation protocol by a multidisciplinary team led to a notable decrease in the average duration of tracheostomy weaning from 2019 to 2022, even amidst the coronavirus pandemic.