Evaluation of the application effect of nurse-led protocol-based weaning in patients with invasive mechanical ventilation in the intensive care unit

doi:10.19983/j.issn.2096-8493.20260082

Abstract

Abstract:

Objective: To compare the application effects of a nurse-led protocolized weaning program with conventional weaning program in intensive care unit (ICU) patients receiving invasive mechanical ventilation, and to provide evidence for clinical weaning practice. Methods: A total of 120 patients receiving invasive mechanical ventilation and admitted to the Emergency ICU and Surgical ICU of Qingpu Hospital Affiliated to Fudan University from January to September 2025 were enrolled and divided into an observation group and a control group, with 60 cases in each group. The control group received conventional weaning, while the observation group received a nurse-led protocolized nursing program (including daily weaning screening, 3-minute spontaneous breathing trial, spontaneous breathing trial, physician-nurse collaborative weaning and extubation, and post-extubation nursing management and monitoring). The daily weaning screening rate, mean duration of mechanical ventilation, weaning failure rate, and ICU length of stay were compared between the two groups. Results: The median (Q₁,Q₃) daily weaning screening rate in the observation group was 100.0% (100.0%, 100.0%), which was higher than that in the control group (66.7% (50.0%, 75.0%)). The duration of mechanical ventilation in the observation group was (73.4±24.8) h, shorter than that in the control group ((82.2±23.1) h). The ICU length of stay in the observation group was (4.9±1.4) d, shorter than that in the control group ((5.8±1.6) d). All differences were statistically significant (Z=9.222, P<0.001; t=1.999, P=0.048; t=3.305, P=0.001). The weaning failure rate was 1.7% (1/60) in the observation group and 3.3% (2/60) in the control group, with no statistically significant difference (χ²=0.342, P=0.559). Conclusion: The nurse-led protocolized weaning can shorten the weaning time, mean duration of mechanical ventilation, and ICU length of stay in patients receiving invasive mechanical ventilation, but has no effect on the weaning failure rate. Overall, it has clinical application value.

Key words: Nurses, Ventilators, mechanical, Comparative study

CLC Number:

R473.5

Xia Lifang, Fan Zhiwen, Zhang Wei, Jin Weiwei. Evaluation of the application effect of nurse-led protocol-based weaning in patients with invasive mechanical ventilation in the intensive care unit[J]. Journal of Tuberculosis and Lung Disease , 2026, 7(3): 308-313. doi: 10.19983/j.issn.2096-8493.20260082

Figures/Tables 3

References 19

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指标	对照组(60例)	观察组(60例)	统计检验值	P值
年龄(岁,$\bar{x}$±s)	68.4±15.1	70.1±15.5	t=-0.608	0.544
性别[例(构成比,%)]			χ²=0.320	0.572
男性	36(60.0)	39(65.0)
女性	24(40.0)	21(35.0)
疾病种类[例(发生率,%)]			χ²=1.933	0.586
腹部手术	21(35.0)	24(40.0)
重症肺炎	13(21.7)	10(16.7)
创伤	15(25.0)	17(28.3)
脓毒性休克	11(18.3)	9(15.0)
APACHE Ⅱ评分(分,$\bar{x}$±s)	16.3±3.7	15.2±3.0	t=1.803	0.074
氧合指数($\bar{x}$±s)	182.3±21.3	185.1±21.7	t=-0.903	0.368