Association Between Ventilator Associated Events and Implementation of Acute Respiratory Distress Syndrome (ARDS) Ventilator Weaning Protocol

BACKGROUND: Acute respiratory distress syndrome (ARDS) is a severe and life-threatening condition that can occur in critically ill patients. Mechanical ventilation is a commonly used intervention with ARDS patients, but weaning patients off the ventilator can be challenging. An ARDSnet-like ventilator weaning protocol was implemented with the goal of reducing triggers for ventilator-associated events (VAEs). METHODS: The implementation of the new protocol was used to complete a retrospective investigation of patient outcomes for 1,233 ventilator periods. Periods were included between April and December 2022 for any ventilated patient lasting at least four days. National Healthcare Safety Network (NHSN) VAE criteria was used to surveille the patient data. Triggers were based on positive end expiratory pressure (PEEP) increases or fraction of inspired oxygen (FiO₂) increases. The pre-set weaning criteria was a reduction by two cmH(2)O per 24 hours. RESULTS: Of the total 1,233 individual ventilator periods, VAE criteria were met in 10%. Of the total 126 periods with VAE, 39.2% met criteria for appropriate protocol implementation. There was a statistically significant relationship between VAE identification and implementation of the protocol. CONCLUSIONS: The implementation of a protocol for ventilator weaning affects the outcome of developing a VAE. The findings emphasize the importance of implementing ARDS weaning protocol as a template to reduce the triggers for VAEs and improve overall patient outcomes.