PURPOSE: To discribe the ventilator weaning experience at Promise Healthcare is a Long Term Acute Care (LTAC) hospital located in Salt Lake City, Utah. The LTAC by design is a long term weaning facility to which patients admitted have failed weaning attempts in an acute care hospital for twenty one (21) days on average.
METHODS: Thirty Five (35) long term ventilator patients from Promise Healthcare, Nineteen (19) from the West Campus and Sixteen (16) from the East Campus were admitted for care between October 2004 and May 2006 and included in this study. This study was conducted in a retrospective manner by chart review and abstraction. The data elements were decided by consensus of a student research group after reviewing the revelant literature. The data transcription was checked against source documents by two indendent groups for accuracy.
RESULTS: Total Number of Patients 35, All Cause Mortaility (Male 5, Female 2) total 7 (23)%, Ventilator Free Days > 72 hours 25/33 (76)%, Mean Hospital Length of Stay Days 37.4 ± 23.2, Mean Days to Wean from the Ventilator 27.4 ± 25.4, Study period Oct 04-May 05.
CONCLUSION: Patients admitted to Promise Healthcare were successfully weaned from mechanical ventilator support 76% of the time in this cohort. The average number of days to wean patients was 27.4 from admission. The average Hospital Lenght of Stay was 37.4 days from admission. The APACHE II score at admission averaged 19 ± 6.8 on the West and 16 ± 3.7 on the East Campus.
CLINICAL IMPLICATIONS: Long term mechanically ventilated patients that were deemed unweanable by acute care hopsitals and transferred to Promise Healthcare a Long Term Acute Care (LTAC) provider in Utah were able to be weaned 76% of the time by day 27.4. The LTAC by nature is focused on slower paced, patient/family centered approach to mechanical ventilation and weaning. Many patients deemed unweanable may in fact be extubated and not require ventilatory support after transferred to a LTAC Hospital.
DISCLOSURE: Loren Greenway, No Product/Research Disclosure Information; Consultant fee, speaker bureau, advisory committee, etc. I’m an educational/research consultant for promise for which I’m paid a stipen of $1,500.00 per month