PT  - JOURNAL ARTICLE
AU  - Kristina E Ramirez
AU  - Richard W Wettstein
AU  - Sylvia Cuevas
AU  - Donna D Gardner
AU  - Ruben D Restrepo
TI  - Adherence to an Oxygen-Weaning Protocol in Mechanically Ventilated Adults in the Medical ICU
AID  - 10.4187/respcare.07432
DP  - 2020 Mar 24
TA  - Respiratory Care
PG  - respcare.07432
4099  - http://rc.rcjournal.com/content/early/2020/03/24/respcare.07432.short
4100  - http://rc.rcjournal.com/content/early/2020/03/24/respcare.07432.full
AB  - BACKGROUND: Patients undergoing mechanical ventilation in the ICU often receive supplemental oxygen. If not closely monitored, this may lead to hyperoxia. The use of an oxygen-weaning protocol may reduce this risk by pacing the titration of oxygen therapy to patient needs. ICU protocols are correlated with decreased mortality and length of stay and have great potential for cost savings. The goals of this study were to determine whether the oxygen-weaning protocol at a university-affiliated hospital was followed and to measure the length of time respiratory therapists took to wean patients once the oxygen-weaning parameters were met.METHODS: This was a retrospective chart review of subjects > 18 y of age admitted to the medical ICU who underwent intubation and mechanical ventilation and were placed on an oxygen therapy protocol. The following data were collected: demographics, arterial blood gases, the length of time to change FIO2 after meeting weaning parameters, and the percent change in FIO2.RESULTS: Data were collected from 30 subjects. The most common oxygen saturation parameter measured via pulse oximetry (SpO2) used to initiate weaning oxygen was 92%. The mean ± SD FIO2 administered to subjects was 39.6 ± 15.3% prior to extubation. The majority of subjects exhibited adequate oxygenation prior to extubation (mean ± SD): PaO2 99.3 ± 6.7 mm Hg, SaO2 95.1 ± 26.9%. The mean ± SD length of time to the first change in FIO2 from the time a subject met the weaning criteria was 9.1 ± 10.6 h (range 1–39 h; interquartile range 2–13 h).CONCLUSIONS: Subjects admitted to the medical ICU who were intubated, mechanically ventilated, and placed on the oxygen therapy protocol experienced a significant delay in oxygen weaning. Closer monitoring and adherence to the oxygen-weaning protocol should be considered to reduce the potential risk for hyperoxia.