An Investigation of Weaning from Ventilator Criteria in Iran: A Systematic Review

Abstract

Abstract Background: Long-term mechanical ventilation can adversely affect patients and the healthcare system. Ventilator-dependent patients need specialized care, frequent monitoring, and long-term hospitalization in ICUs, increasing patient costs and intensive care units' occupation. 40% of the total time when the patient is connected to the mechanical ventilation device is devoted to the weaning process of these patients from the mechanical ventilation device. Therefore, it is necessary to separate the patient undergoing mechanical ventilation as soon as possible. Consequently, we conducted a systematic review study to investigate the best methods of weaning intensive care unit patients from the ventilator in Iran. Method: In this systematic review, studies relevant to the latest methods according to PRISMA 2020 of weaning the patient from the ventilator in Iran, after transferring the studies to EndNote software and removing duplicate studies, were examined by two researchers separately. In case of disagreements, a third collaborator reassessed the study and made the final decision. The evaluation of the studies was done during the primary, secondary, qualitative evaluation, and data extraction stages. Results: In the primary search in the researchers' chosen databases, we identified 1103 possible related articles and transferred them to EndNote software used for data management. We excluded 235 duplicate articles from our survey. In the screening stage, 457 articles were excluded from the remaining 868 studies by reading the article's title and its abstract according to inclusion and exclusion criteria. In the stage of evaluating the eligibility, from 411 studies, researchers excluded 402 articles by researchers through reading the full text of articles based on the inclusion and exclusion criteria due to their irrelevance. Based on STROBE and CONSORT checklists, the qualitative evaluation stage excluded no article from the remaining 9 studies due to poor methodological quality. Finally, nine studies were included in the final analysis. Conclusion: Identifying and adopting strategies to promote successful mechanical ventilation weaning is a priority for research and quality improvement. This study has reviewed the evidence related to various methods designed to promote the success of weaning from the ventilator in Iran. However, it seems that more studies are needed to discover the effectiveness of ventilator-weaning strategies.