Fatigue and prealbumin levels during the weaning process in long-term ventilated patients

The study addresses two conditions that afflict long-term ventilated adult patients during the weaning process: fatigue and protein calorie malnutrition. The majority of the study was conducted in a four-bed respiratory unit of a tertiary care, urban medical center over 15 months. Sixty-one patients were assessed non-randomly for the study. Of the 61 patients, 45 were disqualified and five were removed from the study. The 11 remaining patients were able to complete the protocol. Fatigue scores were measured using the numerical rating scale of the Lee Fatigue Scale and protein calorie malnutrition was measured using serum prealbumin levels. Levine's Principles of Conservation (energy and structural integrity) guided the analysis for the longitudinal, descriptive design of this study. Findings revealed that LTV patients had distinctive fatigue trends during the weaning course. Fatigue scores were lower in the morning and rose after a weaning trial. Certain factors affected fatigue trends. Patients having a rest period before a weaning trial and during a weaning trial helped to reduce fatigue. Findings revealed an inverse relationship between fatigue and energy as would be expected during the weaning process. Overall, patients in the study experienced moderate to severe fatigue and low to moderate energy throughout their entire weaning process. PAB levels did not have a statistically significant association with fatigue; however, emerging trends were noted on particular patients who had subnormal to critically low PAB levels. Essentially, “morning” fatigue levels rose as PAB levels dropped and lowered as PAB levels rose. Likewise, “morning” energy levels lowered as PAB levels dropped and raised as PAB levels rose.