2 CHEST Annual Meeting dhe LOS ANGELES 2016 OGTOBER 22-26 SESSION TITLE: Mechanical Ventilation & Respiratory Failure I SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM ‘Timing of Spontaneous Awakening and Breathing ‘Trial Affects Duration of Mechanical Ventilation Galo Sanchez Palacios MD* Jennifer Quinn RT Meredith Stein JD Joseph Carrington DO Kinjal Sheth MD. Paul Seceybor PA-C Kate Curran RN; and Jaime Barnes DO Sinai Hospital of Baltimore, Baltimore, MD. PURPOSE: Prolonged mechanical ventilation leads to negative outcomes. Daly paired Spontancous Awakening Trials (SATs) ‘with Spontaneous Breathing Trials (SBTs) have improved Duration Of Mechanical Ventilation (DOMV), but optimal timing for SATS/SBTs is unknown. We hypothesized changing the time of day to 0500 from 0800 would improve compliance with daily SAT/SBTs and decrease DOMY. METHODS: Prospective cohort study (0176) in a mixed medical-surgical 16-bed ICU at a community hospital. All continuous patients requiring intubation from June-August 2014 (n—81) and June-August 2015 (n—95) were included. Time-of-day for SATS/SBTs was changed to 0500 from O8O0. Statistical analysis performed with MedCale 14.8. RESULTS: DOMV significantly decreased from an average 3:82 days (95% CI 2.89-4.75) to 2.53 days (95% C1 2.02-3.03, P=000125). Fisher's Exact Test of Independence showed no statistical difference of reintubation frequencies (4.9% pre vs 17.3% post, p=0.539) or self-extubation frequencies (1.2% pre vs 6.2% post, P=1.00),'T-Tests showed no statistical difference between SBI attempts per patient (mean=1.85, 95% CI 1.-2.37 vs mean=1.59, 95% CI 1.17-201, p=0.427), SBI screens passed per patient (pre mean=0.89, 95% CI 0.47-1.32 vs post mean—0.63, 95% CI 0.50-0.76, p=0.212), or SAT screens per patient (pre Imean=1.26, 95% Cl 0.48-2.04 ys post mean=1,08, 95% CI 0.96-1.21, p=0.636). (CONCLUSIONS: Change in time-of day for SB1s from 0800 to 0500 was associated with significant decrease in DOMY with no change in compliance with SAT screens, SBT screens, or number of SBT attempts. CLINICAL IMPLICATIONS: Prolonged DOMY is associated with higher LOS, mortality, infection rates, and costs, Determining best practices for SATS/SBTS is essential for ventilator liberation. Performing SATS/SBTs at atime with fewer distractions allowed for focused best-practices and improved DOMV in our study. DISCLOSURE: The following authors have nothing to disclose: Galo Sanchez Palacios, Jennifer Quinn, Meredith Stein, Joseph Carrington, Kinja Sheth, Paul Szczybor, Kate Curran, Jaime Barnes ‘No Product/Rescarch Disclosure Information Dor: hupu/ddoiorg/10.1016) chest 201608330 ‘Copyright ©2016 American Collegeof Chest Physicians. Pubished by Elsevier Inc.All ghts reserved. Journal publications. chestnet.org 317A Descarga para Ancnyicus Uses (0) en University of Antogia de Cline spo lever en febrero 18,2023 Para use pesoaal cxrinivamente No so pesttes curs uss aun aulanzarion, Copyght ©2035, Elsevier int. Todos lo deface servo EY) eda) 0) a tle)