HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Take the CE Test Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Epstein, C. D. Articles by Peerless, J. R. Search for Related Content PubMed PubMed Citation Articles by Epstein, C. D. Articles by Peerless, J. R.

CE Online

Weaning Older Patients From Long-term Mechanical Ventilation: A Pilot Study

• Background As older persons in the intensive care unit increasingly require long-term mechanical ventilation, accurate indications of readiness for weaning from ventilatory support are needed to avoid premature extubation.

• Objective To describe temporal changes in pulmonary and systemic variables in older adults receiving long-term mechanical ventilation.

• Methods After 3 days of unsuccessful attempts at weaning from ventilatory support, 10 trauma and surgical patients more than 60 years old were monitored daily. Previously reported predictors of the duration of mechanical ventilation and weaning outcome were measured, including hemodynamic and gas exchange variables, oxygen cost of breathing, and the score on the Burns Weaning Assessment Program.

• Results The 6 patients who could be weaned from ventilatory support were younger (median age, 71.5 years) than the 4 patients who could not be weaned (median age, 80 years). Patients who could be weaned were ready for weaning by day 11 of their stay in the intensive care unit and required an additional 5.5 days of mechanical ventilation; those who could not be weaned were not ready for weaning until day 17. All patients initially had increases in oxygen consumption during weaning; those who were successfully weaned had decreases before extubation. Respiratory rate, maximal inspiratory pressure, the ratio of PaO₂ to fraction of inspired oxygen, and mean arterial pressure were higher in patients who could be weaned, and oxygen cost of breathing and central venous pressure were lower.

• Conclusion Further study of weaning in older adults is warranted.

To receive CE credit for this article, visit the American Association of Critical-Care Nurses’ (AACN) Web site at http://www.aacn.org, click on "Education" and select "Continuing Education," or call AACN’s Fax on Demand at (800) 222-6329 and request item No.1155.

This article has been cited by other articles:

				C. D. Epstein and J. R. Peerless Weaning Readiness and Fluid Balance in Older Critically Ill Surgical Patients Am. J. Crit. Care., January 1, 2006; 15(1): 54 - 64. [Abstract] [Full Text] [PDF]

				C Nielson and D Wingete Intensive care and invasive ventilation in the elderly patient, implications of chronic lung disease and comorbidities Chronic Respiratory Disease, January 1, 2004; 1(1): 43 - 54. [Abstract] [PDF]