Thanks to the popularity of medical dramas such as ER, Grey’s Anatomy, and others, almost everyone is familiar with the concept of intubation and supported breathing. Intubation is frequent, visually impactful, and makes for a great show. These patients inevitably recover, they are removed from their breathing apparatus, cough once or twice, and are discharged. However, mechanical ventilation is far more complex than these portrayals, and with the assistance of a Canadian Institutes of Health Research Knowledge Translation Strategy Unit grant, Bloomberg Nursing Professor Louise Rose is working to improve the effectiveness of techniques for weaning and building lung capacity for critically ill patients receiving mechanical ventilation in acute care settings.
Despite more than two decades of research, the reasons for failure to breathe without ongoing support from a ventilator remain unclear. Some techniques, such as cough augmentation that promote increased lung capacity and an assisted cough, have been used extensively to prevent and manage respiratory complications in patients with progressive diseases such as Muscular Dystrophy. These techniques may improve outcomes for patient experiencing acute respiratory failure and critical illness. Rose and her co-investigators will conduct a systematic approach of randomized studies and non-randomized studies to evaluate the benefits and possible harms of these techniques.
“Managing the critically ill patients experiencing difficulty weaning from the ventilator is challenging” says Rose. “The research we conduct will contribute to knowledge regarding the effectiveness of cough augmentation strategies that may lead to improvements in patient outcomes, and potentially decrease costs to the healthcare system by reducing the need for re-intubation.”
Findings from the research study will be shared with policy makers involved in funding decisions regarding mechanical cough assist devices, and for the formation of evidence-based policy. By identifying potential patient indications, possible safety concerns, and the potential effectiveness of cough augmentation techniques, Rose’s study will work to close existing gaps in research on weaning from mechanical ventilation.