Journal of the Medical Association of Thailand Vol 93, No 8:AUGUST 2010 0125-2208 93 8 2010 Aug Protocol-Directed vs. Physician-Directed Weaning from Ventilator in Intra-Abdominal Surgical Patients 930 EN Onuma Chaiwat Niyomporn Sarima Kussama Niyompanitpattana Chulaluk Komoltri Yuthana Udomphorn Suneerat Kongsayreepong Original Article One hundred intra-abdominal surgical patients requiring mechanical ventilation for more than 24hours were randomly assigned to receive either protocol-directed (n = 51) or physician-directed (n = 49) weaning frommechanical ventilation. Patients assigned to the protocol-directed weaning group underwent daily screening and a spontaneousbreathing trial by nursing staff.Outcomes: The primary outcome was the duration of mechanical ventilation. The median duration of mechanical ventilation was 40 and 72 hrs in protocol-directed and physician-directedgroups, respectively (p < 0.001). Two patients in the protocol-directed group and three patients in the physician directedgroup were re-intubated within the first 72 hours after extubation (p = 0.61). Daily screening of respiratory function in intra-abdominal surgical patients followed by trials of spontaneousbreathing performed by nurses resulted in a shorter duration of mechanical ventilation when compared to traditionalphysician-directed weaning. Mechanical ventilation Weaning Intensive care unit Outcomes Protocol-directed weaning Nursing