Prepared by:
Department of Medicine and Clinical Epidemiology & Biostatistics
McMaster University, Hamilton, Ontario, Canada
Deborah Cook, M.D., Principal Investigator
Maureen Meade, M.D.
Gordon Guyatt, M.D.
Lauren Griffith, M.Sc.
Lynda Booker, B.A.
File Name Description Software Version File Size ____________________________________________________________________________________ 01front.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 45KB 6 pages Contents: Title Page, Preface, Acknowledgements, Structured Abstract ____________________________________________________________________________________ 02cont.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 31KB 10 pages Contents: Table of Contents, List of Tables, List of Figures, List of Appendixes ____________________________________________________________________________________ 03summ.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 33KB 5 pages Contents: Summary ____________________________________________________________________________________ 04chap1.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 32KB 13 pages Contents: Chapter 1. Introduction: Organization, Mechanical Ventilation and Weaning from Mechanical Ventilation, Questions on Weaning from Mechanical Ventilation, Importance of Optimizing the Weaning Process, How Can Clinicians Conduct an Optimal Wean ____________________________________________________________________________________ 05chap2.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 32KB 7 pages Contents: Chapter 2. Methodology: Eligibility Criteria, Search for Relevant Studies, Data Abstraction and Assessment of Methodologic Quality, Statistical Syn- thesis, Controlled Comparison of Alternative Treatments, Observational Studies Addressing Prediction of Successful Weaning and Duration of Venti- lation, Methodology for Pooling Study Results, Other Types of Studies ____________________________________________________________________________________ 06chap3.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 136KB 34 pages Contents: Chapter 3. Results: Randomized and Nonrandomized Controlled Trials, Controlled Trials of Discontinuation Assessment Strategies, Controlled Trials of Progressive Reduction in Mechanical Support, Controlled Trials Comparing Alternative Ventilation Modes Lasting Less Than 48 Hours, Con- trolled Trials Comparing Weaning Protocols to Physician-Directed Weaning, Controlled Trials of Early Versus Late Extubation Following Cardiac Surgery, Controlled Trials of Corticosteroids to Prevent Postextubation Airway Complications, Controlled Trials of Enteral Nutrition, Randomized Trials of Miscellaneous Studies, Observational Studies Addressing Prediction of Successful Weaning and Duration of Ventilation, Qualitative Studies of Weaning From Mechanical Ventilation, Observational Studies Describing Patient Experience During Weaning ____________________________________________________________________________________ 07chap4.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 74KB 15 pages Contents: Chapter 4. Conclusions and Future Research: Controlled Trials of Unassisted Ventilation, Controlled Trials of Progressive Reduction in Mechanical Support, Controlled Trials Comparing Alternative Ventilation Modes for Weans Lasting Less Than 48 Hours, Controlled Trials of Early Versus Late Extubation Follow- ing Cardiac Surgery, Controlled Trials Comparing Weaning Protocols to Physician- Directed Weaning, Controlled Trials of Corticosteroids to Prevent Post- extubation Airway Complications, Controlled Trials of Enteral Nutrition, Controlled Trials: Miscellaneous Studies, Observational Studies Addressing Prediction of Successful Weaning and Duration of Ventilation, Observational Studies Describing Patient Experience During Weaning, Strengths and Limitations of This Review, Summary of Inferences From this Review, Summary of Recommendations for Future Research ____________________________________________________________________________________ 08refs.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 45KB 8 pages Contents: References ____________________________________________________________________________________ 09biblio.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 264KB 69 pages Contents: Biblography ____________________________________________________________________________________ 10appa.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 11KB 3 pages Contents: Appendix A. Search Strategy: MEDLINE and HealthSTAR for Interventional Studies ____________________________________________________________________________________ 11appb.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 8KB 2 pages Contents: Appendix B. Search Strategy: MEDLINE and HealthSTAR for Observational Studies ____________________________________________________________________________________ 12appc.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 11KB 2 pages Contents: Appendix C. Search Strategy: CINAHL for Interventional Studies ____________________________________________________________________________________ 13appd.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 9KB 2 pages Contents: Appendix D. Search Strategy: CINAHL for Observational Studies ____________________________________________________________________________________ 14appe.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 8KB 2 pages Contents: Appendix E. Search Strategy: EMBASE for Interventional Studies ____________________________________________________________________________________ 15appf.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 9KB 3 pages Contents: Appendix F. Search Strategy: EMBASE for Observational Studies ____________________________________________________________________________________ 16appg.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 14KB 1 page Contents: Appendix G. Relevance Form ____________________________________________________________________________________ 17apph.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 13KB 1 page Contents: Appendix H. Selection Criteria for Articles About Weaning ____________________________________________________________________________________ 18appi.doc Microsoft Word® Document MS Word® 97 SR-1 263KB 1 page Contents: Appendix I. Extraction Form for General Characteristics of All Studies ____________________________________________________________________________________ 19appj.doc Microsoft Word® Document MS Word® 97 SR-1 393KB 3 pages Contents: Appendix J. Extraction Form for Randomized Clinical Trials ____________________________________________________________________________________ 20appk.doc Microsoft Word® Document MS Word® 97 SR-1 276KB 1 page Contents: Appendix K. Extraction Form for Nonrandomized Controlled Clinical Trials ____________________________________________________________________________________ 21appl.doc Microsoft Word® Document MS Word® 97 SR-1 348KB 1 page Contents: Appendix L. Extraction Form for Observational Studies ____________________________________________________________________________________ 22appm.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 16KB 3 pages Contents: Appendix M. Acronyms and Abbreviations ____________________________________________________________________________________ 23etbl01.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 26KB 1 page Contents: Evidence table 1. Quality Indicators: Nitrates vs. calcium antagonist ____________________________________________________________________________________ 24etbl02.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 35KB 2 pages Contents: Evidence table 2. Quality indicators: Beta-blockers vs. nitrates ____________________________________________________________________________________ 25etbl03.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 15KB 1 page Contents: Evidence table 3. Outcomes results: Cardiac death or nonfatal MI, beta-blockers vs. calcium antagonists ____________________________________________________________________________________ 26etbl04.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 20KB 1 page Contents: Evidence table 4. Outcomes results: Angina episodes, beta-blockers vs. calcium antagonists ____________________________________________________________________________________ 27etbl05.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 64KB 5 pages Contents: Evidence table 5. Outcomes results: Nitroglycerin use, beta-blockers vs. calcium antagonists ____________________________________________________________________________________ 28etbl06.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 61KB 6 pages Contents: Evidence table 6. Outcomes results: Exercise time to ischemia, beta-blockers vs. calcium antagonists ____________________________________________________________________________________ 29etbl07.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 150KB 34 pages Contents: Evidence table 7. Outcomes results: Adverse events, beta-blockers vs. calcium antagonists ____________________________________________________________________________________ 30etbl08.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 35KB 7 pages Contents: Evidence table 8. Outcomes results: Side effects, beta-blockers vs. calcium antagonists ____________________________________________________________________________________ 31etbl09.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 30KB 5 pages Contents: Evidence table 9. Outcomes results: Cardiac death or nonfatal MI, nitrates vs. calcium antagonists ____________________________________________________________________________________ 32etbl10.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 88KB 12 pages Contents: Evidence table 10. Outcomes results: Angina episodes, nitrates vs. calcium antagonists ____________________________________________________________________________________ 33etbl11.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 32KB 3 pages Contents: Evidence table 11. Outcomes results: Nitroglycerin use, nitrates vs. calcium antagonists ____________________________________________________________________________________ 34etbl12.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 47KB 10 pages Contents: Evidence table 12. Outcomes results: Exercise time to ischemia, nitrates vs. calcium antagonists ____________________________________________________________________________________ 35etbl13.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 659KB 45 pages Contents: Evidence table 13. Outcomes results: Adverse events, nitrates vs. calcium antagonists ____________________________________________________________________________________ 36etbl14.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 277KB 21 pages Contents: Evidence table 14. Outcomes results: Side effects, nitrates vs. calcium antagonists ____________________________________________________________________________________ 37etbl15.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 47KB 13 pages Contents: Evidence table 15. Outcomes results: Cardiac death or nonfatal MI, beta-blockers vs. nitrates ____________________________________________________________________________________ 38fig01.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 1. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Minute Ventilation, Outcome: Extubation Success ____________________________________________________________________________________ 39fig02.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 2. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Respiratory Rate, Outcome: Extubation Success ____________________________________________________________________________________ 40fig03.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 3. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Rapid Shallow Breathing Index, Outcome: Extubation Success ____________________________________________________________________________________ 41fig04.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 4. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Minute ventilation, Outcome: Successful Discontinuation Assessment and Extubation ____________________________________________________________________________________ 42fig05.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 5. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Respiratory Rate, Outcome: Successful Discontinuation Assessment and Extubation ____________________________________________________________________________________ 43fig06.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 6. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Tidal Volume, Outcome: Successful Discontinuation Assessment and Extubation ____________________________________________________________________________________ 44fig07.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 7. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: Rapid Shallow Breathing Index, Outcome: Successful Discontinuation Assessment and Extubation ____________________________________________________________________________________ 45fig08.tif Tagged Image Format File Generic graphic 350KB 1 page Contents: Figure 8. Weaning predictor analyses: Summary receiver operating characteristics curve Predictor: PImax, Outcome: Successful Discontinuation Assessment and Extubation—Message- Boundary-23880 ____________________________________________________________________________________
AHRQ Publication No. 01-E005
Current as of November 2000
Internet Citation:
Criteria for Weaning from Mechanical Ventilation. File Inventory, Evidence Report/Technology Assessment Number 23. AHRQ Publication No. 01-E005, November 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/mechinv.htm
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