Tracheostomy collars best for ventilator weaning

**NRSKarenRN, BSN, RN** · Feb 23, 2013

Found @ nurse.com

Thursday February 21, 2013

Use of a tracheostomy collar is more effective than a technique that reduces positive airway pressure delivered to the lungs in helping patients regain the ability to breathe on their own after more than 21 days on a ventilator, according to a study....
...The study was led by Amal Jubran, MD, from Edward Hines Jr. Veterans Affairs Hospital in Hines, Ill., RML Specialty Hospital in Hinsdale, Ill., and Loyola University of Chicago Stritch School of Medicine in Maywood, Ill. Jubran and colleagues used a five-day unassisted breathing screening procedure to select participants from among 500 patients enrolled for the study. They selected and randomized 312 patients, with 194 completing the study (118 died or withdrew, but were included in the analysis).
Participants were divided into an early-failure group (0 to 12 hours) or a late-failure group (12 to 120 hours) based on the time they took to fail the screening procedure. They then were randomly assigned to pressure support or a tracheostomy collar for weaning. Successful weaning for both groups was defined as the ability to sustain five days of unassisted breathing....

"The results of the study show that the method of ventilator weaning can significantly improve the outcome of study patients who require prolonged mechanical ventilation at an LTACH facility," Jubran said in the news release.

The researchers found a difference in weaning rates based on the time a patient had taken to fail the screening procedure, with the late-failure group weaning 2.2 times faster with the tracheostomy collar than with pressure support. There was no significant difference in weaning rates between the two techniques for the early-failure group.