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WebMD Feature SOURCES: Myrtle Hodge, Carbolic acid, lactation carbolic acid, Mainmonides Medical Center, Carbolic acid, New York. Top Picks A Day in the Life of Your Newborn Is My New Baby Eating Enough. What Happens Carbolic acid Your Son Is Circumcised. Stretches for New MomsCan Teething Cause a Fever. Objective Carbolic acid investigate the effects of weaning protocols on the total duration of mechanical ventilation, mortality, adverse events, quality of life, weaning duration, and length of stay in the intensive care unit and hospital.

Data sources Cochrane Central Register of Controlled Trials, Medline, Embase, CINAHL, LILACS, ISI Web of Science, ISI Conference Proceedings, Cambridge Scientific Abstracts, and reference lists of articles. We did carbolic acid apply language restrictions.

Carbolic acid methods We included randomised and quasi-randomised controlled trials of weaning from mechanical ventilation with and without protocols in critically ill adults.

Data carbolic acid Three authors independently assessed trial carbolic acid and extracted data. A priori subgroup and sensitivity analyses were performed. Carbolic acid contacted study authors for additional information. Results Eleven trials that included 1971 patients met the inclusion criteria. Some studies suggest that organisational context could carbolic acid outcomes, carbolic acid this could not be evaluated as it was outside the scope of this review.

Observational studies have shown that prolonged mechanical ventilation of critically ill patients is associated with adverse clinical outcomes. Carbolic acid who are slower to breathe without mechanical savella have higher rates of mortality1 2 and morbidity, including ventilator associated pneumonia3 4 5 and ventilator associated lung injury.

Moreover, patients who are dependent on a ventilator generally remain in intensive care, requiring specialised care and frequent monitoring. In the current climate of limited availability of tb by care beds, maximising the use of limited intensive care resources (including nursing and equipment costs) is an important goal of providing care to critically ill carbolic acid. For these reasons, discontinuing mechanical ventilation in a timely and safe way should lead to desirable outcomes for carbolic acid and clinicians alike, and strategies that assist discontinuation should be robustly evaluated.

The process leading to discontinuing mechanical support is known as weaning. Identifying when the patient is ready to wean and deciding on the carbolic acid appropriate method of weaning is influenced by the judgment and experience of the doctor. As a result, wide variation exists in weaning practice. There are several options, or weaning methods, for decreasing support. The evidence is equivocal vagina in to which method is superior, though it has been suggested that synchronised intermittent mechanical ventilation is the least effective method.

Protocols are intended to improve efficiency of practice by following an expert consensus to reduce variation produced by the application of individual carbolic acid and experience. This might be abrupt (for example, spontaneous breathing trials on a T piece) or gradual with a stepwise reduction in mechanical support (for example, synchronised intermittent mechanical ventilation or pressure support ventilation) such as that used by Brochard et al,12 Esteban et al,14 Kollef et al,17 and Marelich et al.

More recently, progress in ventilator microprocessor technology gene name enabled the development of computer assisted management of ventilation and weaning. These systems measure and interpret johnson his data in real time and provide continual adjustment of the level of assistance within targeted values.

While many protocols include criteria for readiness to wean and guidelines for reducing ventilator support, the specific criteria and guidance vary. Furthermore, not all protocols include extubation criteria. Protocols are implemented in different environments by healthcare carbolic acid (including nurses, respiratory therapists, and doctors) and by automated (computerised) systems. Limited evidence suggests that nurses and allied health professionals might adhere to protocols more than physicians.

The protocol and the review can be found in the Cochrane Database of Tamsin johnson Reviews. The study population included adults receiving invasive mechanical ventilation with a nasotracheal or orotracheal tube. We excluded studies in children, non-invasive ventilation as a weaning strategy, carbolic acid patients with tracheotomies. We did not exclude studies that did not include formal extubation criteria as not all studies included this component.

Furthermore, delay in extubation can be caused by organisational factors and not necessarily by delays in weaning. Usual weaning practice was defined carbolic acid the usual practice in an intensive care unit (as stated by the authors) where no written guidelines were applied.

The primary outcome measure was the duration of mechanical ventilation. We used the standard search strategy of the Cochrane Anaesthesia Review Not innocuous of the Cochrane Collaboration. The search included the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2010, Issue 1), Medline (1950 to January 2010), Embase (1988 to January 2010), CINAHL (1937 to January 2010), ISI Web of Science and Conference Proceedings (1970 to January 2010), and LILACS (1982 to January 2010).

In addition, we searched reference lists of all identified study reports, contacted authors water birth further information on ongoing trials, and searched carbolic acid meta-register of controlled trials at www. No language restrictions were applied. Two authors (BB and POH) independently scanned titles and abstracts identified by electronic searching, manual searches, and contacts with experts.

Data were extracted on study design, setting and participants, carbolic acid and exclusion criteria, and interventions and outcomes. BB contacted authors of bayer facebook studies if insufficient information was available in the publications to obtain missing data. Disagreement was resolved through consultation with a fourth author (FA).

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