Weaning from mechanical ventilation in post- operatory cardiac surgery: a clinical trial

Abstract

The cardiac surgery post-operatory nurses from Hospital Universitário Pedro Ernesto use syncronized Intermittent mandatory ventilation (SIMV) as a weaning method. Extubation occurs, in average, eight hours after surgery, what is considered a long period. The study compares the period of mechanical ventilation between two weaning modalities: T-tube and SIMV. The study refers to a randomized, clinical trial and control group. A mechanical ventilation weaning protocol has been developed utilizing T-tube as a way of comparing the current protocol, which utilizes SIMV. A Student t- test has been perfomed for the comparison of both groups, with the help of 3.0 Instat GraphPad. The values were considered significant at p<0,05. It was approved by The Research Ethics Committee of the Institution. In the previous analysis, on comparing the time between the two techniques, the use of T-tube was the modality when the patients were weaned in a shorter period of time (45 minutes). However, the values have not been considered significant due to the small size of the sample (n=30). It has been noted that the higher the level of sedation in the post-operatory phase, the faster the weaning. This finding has been related with the absence of pain felt at this stage; once the patient without pain cooperates in the weaning process. The pain limits the movement. As a result, coughing, deep breathing and change in position will be restrained. Therefore, the patient will be agitated at awakening, being necessary the restraint of his movements in bed, prolonging sedation and extubation.

Keywords

• nursing
• cardiac surgery
• mechanical ventilation