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Percentages. The significance level was P < 0.05. Results Sixty patients were studied (52 men, mean age 64 ?17 years, 18 with chronic obstructive pulmonary disease in threshold group vs 15 in control group). Comparing initial versus final cardiorespiratory variables in both groups, no important differences were observed with exception of PImax (increased from ?3.5 ?14.4 to ?0.2 ?13.4 cmH2O in threshold group and changed from ?7.1 ?9.8 to ?4.4 ?9.6 cmH2O in control group, P < 0.05) and PEmax (increased from 24.7 ?12.7 to 29.4 ?12.1 cmH2O in threshold group and changed from 30.9 ?13.5 to 27.1 ?9.4 cmH2O in control group, P < 0.05). No reduction was observed in the length of weaning (1.87 days with threshold versus 1.98 days in control group, P > 0.05). There was no difference concerning weaning success (73.5 <a href="" title=View Abstract(s)">PubMed ID:</a> with threshold versus 61.5 in control group, P > 0.05). Conclusions Threshold during weaning from MV can cause an increase in both PImax and PEmax but, at least in these preliminary results, it was not associated with a decrease in length of weaning or an increase in weaning success.SCritical CareMarch 2007 Vol 11 Suppl27th International Symposium on Intensive Care and Emergency MedicineP171 Application of treatment bundles reduces days on mechanical ventilation in <a href="">AY 9944</a> critically ill patientsF Bloos1, S M ler1, A Harz1, M Gugel1, D Geil1, K Reinhart2, G Marx2 1University Hospital Jena, Germany; 2Friedrich-Schiller University Jena, Germany Critical Care 2007, 11(Suppl 2):P171 (doi: 10.1186/cc5331) Background Reduction of time on the ventilator is a key concept to avoid complications. Recommendations include semirecumbent positioning (SRP) [1], low tidal volume ventilation (TV = 6 ml/kg) [2], prophylaxis for stress ulcer (SUP) [3], and deep vein thrombosis (DVTP) [4]. The goal of this study was to investigate whether staff training about these treatments decreases days on ventilation. Methods All patients of a 50-bed ICU with mechanical ventilation >24 hours were included. From June 2005 to <a href="" title=View Abstract(s)">PubMed ID:</a> September 2005 (Audit I), patients were examined daily for SRP >30? low tidal volume ventilation, DVTP, and SUP by an independent task force. Afterwards, nurses and physicians were trained for the monitored treatments. Audit II was then performed from March 2006 to June 2006. Results One hundred and thirty-three patients (1,389 ventilatordays) were included in Audit I, 141 patients (1,002 ventilator-days) in Audit II. Data are expressed as the median (interquartile range) or percentage of implementation per ventilator-days (Table 1). On average, low tidal volume ventilation was adopted. DVTP and SUP were well implemented without training. There was no effect on frequency of pneumonia, ICU length of stay, or survival.Table 1 (abstract P171) Audit I APACHE II SRP ( ) TV (ml/kg) DVTP ( ) SUP ( ) Days on ventilation 24 (10) 24.9 6.3 (2.2) 89.5 94.5 6.0 (13) Audit II 25 (11) 49.6 6.4 (2.3) 91.9 94.9 4.0 (7) P 0.387 <0.001 0.154 0.048 0.712 0.(ITSB) using a T-tube as two methods of weaning in a surgical ICU. Methods A total of 104 patients who had been ventilated for more than 48 hours in the postoperative period from October 2005 to October 2006 were enrolled in the study. After fulfilling the weaning checklist they were randomly assigned into two groups: SIMV+PSV group (n = 53), and ITSB group (n = 51). In patients assigned to the SIMV+PSV group, the ventilator rate was initially set at 6? breaths/minute plus PSV of 15 cmH2O and then both reduced, if po.