呼吸器脫離計畫對外科加護病房呼吸器留置時間之統合分析與應用

Effectiveness of the Weaning Protocol and Duration of Mechanical Ventilation in Surgical Intensive Care Units: A Meta-Analysis

賴千惠(Gian-Hui Lai) ； 黃淑芸(Shu-Yun Huang) ； 柯韋伶(Wei-Ling Ko) ； 王美惠(Mei-Huey Wang)

《榮總護理》 32卷3期 (2015/09) Pp. 286-294

https://doi.org/10.6142/VGHN.32.3.286

摘要

本研究目的以系統性文獻回顧呼吸器脫離計畫實施，對外科加護病房呼吸器留置時間之效益。搜尋中英文之次級及初級資料庫共七個。納入文獻條件包括實施內容為呼吸器脫離計畫、外科加護病房病人；結果指標為呼吸器留置時間。排除條件為小兒科或呼吸照護中心；實施內容非呼吸器脫離計畫，或由電腦自動啟動呼吸訓練。共搜尋到234篇文獻，納入4篇研究進行統合分析；結果呈現實施計畫後，呼吸器留置時間的平均差為-35.33小時，95% CI[-41.27,-29.39], p＜.000及-1.25天，95% CI[-1.35, -1.15], p＜.000；住加護病房天數平均差-2.00天，95% CI[-2.12,-1.88], p＜.000。本院應用結果顯示能縮短呼吸器留置時間0.99天，建議訂定專科屬性呼吸器脫離計畫、定期教育訓練與稽核，以提升計畫執行率，藉以縮短呼吸器留置時間。

關鍵字

呼吸器脫離計畫 ； 呼吸器留置時間 ； 外科加護病房

並列摘要

The purpose of this study was to systematically review literature regarding the duration of mechanical ventilation and effectiveness of the weaning protocol in surgical intensive care units (SICUs). Seven Chinese and English secondary and primary databases were searched using the criteria of weaning protocol, SICU, and duration of mechanical ventilation. Studies on pediatric and respiratory care centers, nonweaning protocol, and computer-generated automatic breathing training were excluded. Among the 234 articles screened using the inclusion criteria, four were included in meta-analysis. Results of the duration of mechanical ventilation revealed a mean difference (MD) of 35.33 hours (95% confidence interval (CI)[-41.27, -29.39], p＜.000), and 1.25 days (95%CI[-1.35, -1.15], p＜.000); SICU stay MD was 2.00 days (95%CI[-2.12, -1.88], p＜.000). For improving the effectiveness of the weaning protocol, establishing specialist property for weaning protocol and regular in-service education and audits are crucial.

並列關鍵字

weaning protocol ； surgical intensive care unit ； duration of mechanical ventilation

參考文獻

張美玉 (2012)．脫離準備度之概念分析．榮總護理，30 (1)，95-102。

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