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Journal of critical care · Dec 2020
Predictors of survival after prolonged weaning from mechanical ventilation.
- Christian Warnke, Alexander Heine, Annegret Müller-Heinrich, Christine Knaak, Sigrun Friesecke, Anne Obst, Tom Bollmann, Susanna Desole, Michael Boesche, Beate Stubbe, and Ralf Ewert.
- University Hospital Greifswald, Department of Internal Medicine B, Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, F.-Sauerbruchstr, D-17475 Greifswald, Germany.
- J Crit Care. 2020 Dec 1; 60: 212-217.
PurposeWeaning from mechanical ventilation is a key component of intensive care treatment; however, this process may be prolonged as some patients require care at specialised centres. Current data indicate that weaning from invasive mechanical ventilation is successful in approximately 65% of patients; however, data on long-term survival after discharge from a weaning centre are limited.Materials And MethodsWe analysed predictors of survival among 597 patients (392 men, mean age 68 ± 11) post-discharge from a specialised German weaning centre.ResultsComplete weaning from mechanical ventilation was achieved in 407 (57.8%) patients, and 106 patients (15.1%) were discharged with non-invasive ventilation; thus, prolonged weaning was successful in 72.9% of the patients. The one-year and five-year survival rates post-discharge were 66.5% and 37.1%, respectively. Age, duration of mechanical ventilation, certain clusters of comorbidities, and discharged with mechanical ventilation significantly influenced survival (p < .001). Completely weaned patients who were discharged with a tracheostomy had a significantly reduced survival rate than did those who were completely weaned and discharged with a closed tracheostomy (p = .004).ConclusionsThe identified predictors of survival after prolonged weaning could support therapeutic strategies during patients' intensive care unit stay. Patients should be closely monitored after discharge from a weaning centre.Copyright © 2020. Published by Elsevier Inc.
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