Practice Guideline for Weaning from Mechanical Ventilation: A Meta-Analysis
Keywords:
Meta-Analysis, Practice Guideline, Utilization for Weaning from Mechanical Ventilation, Mechanically Ventilated AdultsAbstract
This meta-analysis research aimed to summarize the best available evidence related to the effectiveness of practice guideline utilization for weaning from mechanical ventilation in mechanically ventilated adults. A systematic search was conducted to retrieve both published and unpublished studies conducted in Thailand from 2005 to 2019. Research instruments included 1) a research screening form, 2) a critical appraisal form, and 3) a data extraction form. The systematic search identified a total of 23 studies on effectiveness of practice guideline utilization for weaning from mechanical ventilation in mechanically ventilated adults. One study was excluded due to a lack of information about research outcomes of sample before using practice guideline for weaning from mechanical ventilation. Demographic data were analyzed using frequency, and percentage. Review Manager Version 5.3 was used for the Meta-analysis to determine the effectiveness of practice guideline utilization with sufficient statistical data. Narrative summarization was used for those with insufficient statistical data. Main results were found as follows.
1. After using practice guideline for weaning from mechanical ventilation in mechanically ventilated adults, sample had less duration of use of ventilator (z=6.41, p<.001), duration of weaning from mechanical ventilation (z=7.24, p<.001), length of stay (z=8.08, p<.001), expenditure on use of ventilator (z=3.11, p<.05), and rate of re-intubation than before (z=2.21, p<.05).
2. After using practice guideline for weaning from mechanical ventilation in mechanically ventilated adults, sample had more success rate of weaning from mechanical ventilation than before (z=4.66, p<.001).
Per findings, the practice guideline for weaning from mechanical ventilation in mechanically ventilated adults should be disseminated to other organizations for the same standard and optimal outcomes for critically ill patients receiving weaning from mechanical ventilation. In addition, the results of using practice guideline such as rate of ventilator associated pneumonia and clients’ satisfaction should be monitored.
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