Coordinated care improves outcome

Intensive care unit patients are often on mechanical ventilators and there are always questions about how and when to wean them off and allow them to breathe on their own.

One of the problems is the sometimes disjointed medical care. Nurses are often administering the sedatives but the respiratory therapist is adjusting the ventilator and these two activities weren't happening in a coordinated fashion.

This recent study combined these 2 approaches in a more coordinated fashion.

The study was conducted at 4 tertiary care hospitals and it showed that coordinating mechanical ventilation with sedation results in more days of unassisted breathing and earlier intensive care unit (ICU) discharge for older patients.

This current randomized controlled trial combined spontaneous awakening trials (SATs) with spontaneous breathing trials (SBTs).

Older patients on this combined protocol increased their unassisted breathing time by nearly 4 days during the 28-day study compared with patients in the control group and spent 2 fewer days in a coma and 7 fewer days in ICU.

Investigators noted that both the experimental and control groups had physiologic recovery of respiratory function at the same time but the patients in the control group were not awake enough to have their endotracheal tube removed and come off the ventilator entirely.

Once again, communication among caregivers and a more coordinated approach seems to shorten the time of recovery.

Physicians and all healthcare providers can learn from this approach and attempt to communicate more efficiently.