In the context that special weaning units have been advocated as effective alternatives to the ICU for weaning selected patients, we initiated a Respiratory Special Care Unit (ReSCU) at the Cleveland Clinic Hospital in August 1993.
The goals of the ReSCU were the following : (1) to wean ventilator-dependent patients when possible ; and (2) when weaning was not possible, to optimize patient and family instruction for patients going home with ventilatory support.
This study presents our 4-year experience with 212 patients managed in the ReSCU and analyzes clinical features associated with favorable clinical outcomes.
The features of the ReSCU include six private beds in a pulmonary inpatient ward staffed by nurses with special pulmonary expertise ; 24-h respiratory therapy supervision ; bedside and central noninvasive monitoring (ie, continuous pulse oximetry, end tidal capnometry, and ventilator alarms) ; and a multidisciplinary approach involving dietitians, physical therapists, occupational therapists, social workers, and speech pathologists.
All ReSCU patients were cared for primarily by a pulmonary/critical care attending physician and fellow, with consultative input solicited as deemed necessary.
The criteria for admission to the ReSCU included hemodynamic stability ; absence of an arrhythmia requiring telemetry ; and in the attending physician's judgment, the ability to benefit from the ReSCU. (...)
Mots-clés Pascal : Ventilation mécanique, Long terme, Homme, Sevrage, Evolution, Facteur prédictif, Pronostic, Coût, Economie santé, Réanimation respiratoire, Traitement instrumental, Unité spécialisée
Mots-clés Pascal anglais : Mechanical ventilation, Long term, Human, Weaning, Evolution, Predictive factor, Prognosis, Costs, Health economy, Respiratory intensive care, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0458979
Code Inist : 002B27B02. Création : 22/03/2000.