Construção de um protocolo estruturado para desmame de ventilação mecânica em pacientes adultos traqueostomizados

Abstract

The use of tracheostomy is a widespread factor in the current scenario of Intensive Care Units (ICUs), it favors pulmonary hygiene, can reduce hospitalization time, accelerate rehabilitation, and reduce sedatives, in addition to being of great importance in terms of respect the evolution of ventilatory weaning. This process, according to the literature observed, corresponds to approximately 40% of the time the patient remains on mechanical ventilation, demonstrating the complexity and delay in maintaining spontaneous ventilation. Current literature shows that the use of protocols and the systematic identification of patients who may be eligible for this ventilatory weaning protocol can significantly reduce the time required. Therefore, this work aims to: Build and validate a protocol for weaning from mechanical ventilation in adult tracheostomized patients. Methodological study type work with a qualitative approach, in which, after a systematic review, a ventilatory weaning protocol was created, with evaluation by qualified professionals who, after accessing the protocol and its justification, validated its use in a hospital environment. Results: The correlation between the experts' responses was addressed by the Cronbach index coefficient and given a value of 0.951. The intraclass correlation coefficient (ICC) was significant at a value of 0.951 for the average measurements, indicating good consistency and reliability in the questionnaire. The ventilation weaning process in patients undergoing tracheostomy should be considered as a determining factor in the patient's prognosis, and the fact that it is structured and standardized still proposes a mission for professionals working in the ICU. However, there is still little scientific research available on this topic, which often requires more robust methodology studies, such as multicenter studies, samples with a larger number of subjects and randomized studies.