Liberation From Mechanical Ventilation in Critically Ill Adults

被引：111

作者：

Schmidt, Gregory A. ^{[1
]}

Girard, Timothy D. ^{[2
]}

Kress, John P. ^{[3
]}

Morris, Peter E. ^{[4
]}

Ouellette, Daniel R. ^{[5
]}

Alhazzani, Waleed ^{[6
]}

Burns, Suzanne M. ^{[7
]}

Epstein, Scott K. ^{[8
]}

Esteban, Andres ^{[9
]}

Fan, Eddy ^{[10
]}

Ferrer, Miguel ^{[12
]}

Fraser, Gilles L. ^{[13
]}

Gong, Michelle Ng ^{[14
,15
]}

Hough, Catherine L. ^{[16
]}

Mehta, Sangeeta ^{[11
]}

Nanchal, Rahul ^{[17
]}

Patel, Sheena ^{[18
]}

Pawlik, Amy J. ^{[19
]}

Schweickert, William D. ^{[20
]}

Sessler, Curtis N. ^{[21
]}

Strom, Thomas ^{[22
]}

Wilson, Kevin C. ^{[23
]}

Truwit, Jonathon D. ^{[24
]}

机构：

[1] Univ Iowa, Div Pulm Crit Care & Occupat Med, Iowa City, IA USA

[2] Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA USA

[3] Univ Chicago, Sect Pulm & Crit Care, Chicago, IL 60637 USA

[4] Univ Kentucky, Dept Pulm Crit Care & Sleep Med, Lexington, KY USA

[5] Henry Ford Hosp, Dept Pulm Dis Serv, Detroit, MI 48202 USA

[6] McMaster Univ, Dept Med, Hamilton, ON, Canada

[7] Univ Virginia Hlth Syst, Dept Nursing, Charlottesville, VA USA

[8] Tufts Univ, Sch Med, Div Pulm Crit Care & Sleep Med, Boston, MA 02111 USA

[9] Hosp Univ Getafe, Dept Intens Care Unit, Madrid, Spain

[10] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

[11] Univ Toronto, Div Respirol, Toronto, ON, Canada

[12] Univ Barcelona, Hosp Clin, Dept Pneumol, Resp Inst,IDIBAPS,CibeRes CB06 06 0028, Barcelona, Spain

[13] Maine Med Ctr, Portland, ME 04102 USA

[14] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA

[15] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA

[16] Univ Washington, Harborview Med Ctr, Div Pulm & Crit Care Med, 325 9Th Ave, Seattle, WA 98104 USA

[17] Med Coll Wisconsin, Dept Pulm & Crit Care Med, Milwaukee, WI 53226 USA

[18] Amer Coll Chest Phys, Glenview, IL USA

[19] Univ Chicago, Med Ctr, Dept Therapy Serv, Chicago, IL 60637 USA

[20] Univ Penn, Perelman Sch Med, Div Pulm Allergy & Crit Care, Philadelphia, PA 19104 USA

[21] Virginia Commonwealth Univ, Sch Med, Dept Internal Med, Div Pulm & Crit Care, Richmond, VA USA

[22] Univ Southern Denmark, Dept Anaesthesia & Intens Care Med, Odense, Denmark

[23] Boston Univ, Pulm Allergy Sleep & Crit Care Med, Boston, MA 02215 USA

[24] Froedtert, Div Pulm & Crit Care Med, Milwaukee, WI USA

来源：

CHEST | 2017年 / 151卷 / 01期

关键词：

evidence-based medicine; guidelines; mechanical ventilation; DECISION ETD FRAMEWORKS; TRANSPARENT APPROACH; GRADE EVIDENCE; COLLEGE;

D O I：

10.1016/j.chest.2016.10.037

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST). METHODS: A multidisciplinary panel posed six clinical questions in a population, intervention, comparator, outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The Evidence-to-Decision framework was applied to each question, requiring the panel to evaluate and weigh the importance of the problem, confidence in the evidence, certainty about how much the public values the main outcomes, magnitude and balance of desirable and undesirable outcomes, resources and costs associated with the intervention, impact on health disparities, and acceptability and feasibility of the intervention. RESULTS: Evidence-based recommendations were formulated and graded initially by subcommittees and then modified following full panel discussions. The recommendations were confirmed by confidential electronic voting; approval required that at least 80% of the panel members agree with the recommendation. CONCLUSIONS: The panel provides recommendations regarding liberation from mechanical ventilation. The details regarding the evidence and rationale for each recommendation are presented in the American Journal of Respiratory and Critical Care Medicine and CHEST.

引用

页码：160 / 165

页数：6

共 4 条

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Brignardello-Petersen, Romina ;

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[3] An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically III Adults [J].

Girard, Timothy D. ;

Alhazzani, Waleed ;

Kress, John P. ;

Ouellette, Daniel R. ;

Schmidt, Gregory A. ;

Truwit, Jonathon D. ;

Burns, Suzanne M. ;

Epstein, Scott K. ;

Esteban, Andres ;

Fan, Eddy ;

Ferrer, Miguel ;

Fraser, Gilles L. ;

Gong, Michelle Ng ;

Hough, Catherine L. ;

Mehta, Sangeeta ;

Nanchal, Rahul ;

Patel, Sheena ;

Pawlik, Amy J. ;

Schweickert, William D. ;

Sessler, Curtis N. ;

Strom, Thomas ;

Wilson, Kevin C. ;

Morris, Peter E. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2017, 195 (01) :120-133

[4]

Ouellette DR, 2017, CHEST, V151, P166, DOI 10.1016/j.chest.2016.10.036

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