Introduction
Mechanical ventilation was a path-breaking intervention in management of
critically ill patients in the 19thcentury. Over the
years, mechanical ventilation has revolutionised critical care
management and saved many lives. However, prolonged mechanical
ventilation has its own complications.[1] Weaning from ventilator is
considered to be a blend of art and science. The steps in the process
include assessing the readiness for weaning, giving a spontaneous breath
trial (SBT) and finally the decision to extubate.[1,2] These steps
constitute 40% of the time a patient spends on mechanical ventilation,
and delay in any of them will result in an overall delay in the process
of weaning.[3] Attempts have been made to introduce objectivity in
the process by introduction of protocols in pursuit of hastening the
process of liberation from mechanical ventilation. Most of the studies
have been conducted in resource-rich settings and have shown significant
improvement in adherence to evidence-based protocols after their
introduction and reinforcement via continuous education of the
physicians, which has led to a higher weaning success.[4-6] There is
a scant literature on adherence to evidence-based protocols of weaning
in resource- limited settings and effect of educational interventions on
the same. Current evidence suggests the need for weaning protocols to
account for the complexities of social and cultural environment in which
they are to be implemented, particularly in resource-limited settings.
[7] We conducted this study to assess the current weaning practices
and impact of implementation of evidence-based weaning protocol in a
high-burden tertiary care ICU setting.