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				A Study on the Physiological and Psychological Factors related to Successful Weaning 
from a Mechanical Ventilator														
			
			Cho Ja Kim, Hwasoon Kim, Yeon Soo Jang, Eun Sung Kim			
				Journal of Korean Academy of Nursing 2000;30(4):995-1005.   Published online March 29, 2017			
									DOI: https://doi.org/10.4040/jkan.2000.30.4.995
							
							 
				
										
										 Abstract  PDF
This study was performed to identify the physiological and psychological variables related to successful weaning 
from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation 
therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following 
physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, 
static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean 
arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, 
perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. 
Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning 
failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) 
perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who 
successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as 
follows; 
Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were 
mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in 
long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 
in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the 
failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway 
pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a 
predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous 
breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the 
failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those 
of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between 
the both groups, therefore future studies are needed to focus on searching other variables besides physiological 
parameters related to weaning outcome. |