Level of knowledge of nursing staff in the process of weaning from Mechanical Ventilation in the ICU

Abstract

Mechanical ventilation (MV) has its roots in ancient medicine, with references found in the writings of Hippocrates. However, its modern development began with key milestones such as Woillez’s manual ventilator (19th century) and Emerson’s “iron lungs” (1920s), which were vital during the polio epidemic. In the 1950s, the introduction of positive pressure ventilators significantly reduced mortality rates, allowing around 30% of ICU patients to be successfully weaned off. Today, MV is essential for managing respiratory failure, improving gas exchange, and reducing the work of breathing.The weaning process from MV is complex and involves several stages: pre-weaning (patient assessment and preparation), ongoing weaning (gradual disconnection or T-piece trial), and post-extubation (monitoring to prevent deterioration and deciding on non-invasive ventilation or reintubation). Successful weaning is based on the resolution of the underlying cause, the patient's adequate level of consciousness, and haemodynamic stability. Nursing staff played a crucial role in this process. They assessed muscular weakness and neuromuscular disorders, implemented weaning protocols, and possessed in-depth knowledge of the equipment and procedures involved. Continuous training and the ability to handle challenges in care, such as high costs and resource management, were essential. Furthermore, nurses developed specific competencies and leadership skills to adapt to the constantly evolving environment of intensive care. Active nursing involvement not only optimizes weaning outcomes but also reduces complications and enhances the quality of life for critically ill patients.