• Dario Villalba, Emiliano Navarro, Amelia Matesa, Andrés Brusco, Virginia Morales, Gastón Germán Morel Vulliez, Emilio Sebastián Rositi, Luciana Prieto, Mauro Javier Bosso, Silvana De Paoli, Alejo Cotero, Juan Nadur, Marcela Santini, Marcelo Alonso, Florencia Larocca, Carlos Duarte, Verónica García, Romina Campodónico, Gabriel Musso, Mariel Leingruber, Aldana Soledad Morales, Analía Segura, María Eugenia Vallory, PieruzziSelva Del CarmenSDCSEMED, Ciudad Autónoma de Buenos Aires, Argentina., Pablo Sebastián Pascal, and Eduardo Luis De Vito.
• Clínica Basilea, Ciudad Autónoma de Buenos Aires, Argentina. dariovillalba79@gmail.com.
• Respir Care. 2024 Jan 24; 69 (2): 202209202-209.

BackgroundEpidemiological data on patients with COVID-19 referred to specialized weaning centers (SWCs) are sparse, particularly in low- and middle-income countries. Our aim was to describe clinical features, epidemiology, and outcomes of subjects admitted to SWCs in Argentina.MethodsWe conducted a prospective, multi-center, observational study between July 2020-December 2021 in 12 SWCs. We collected demographic characteristics, laboratory results, pulmonary function, and dependence on mechanical ventilation at admission, decannulation, weaning from mechanical ventilation, and status at discharge. A multiple logistic model was built to predict home discharge.ResultsWe enrolled 568 tracheostomized adult subjects after the acute COVID-19 phase who were transferred to SWCs. Age was 62 [52-71], males 70%, Charlson comorbidity index was 2 [0-3], and length of stay in ICU was 42 [32-56] d. Of the 315 ventilator-dependent subjects, 72.4% were weaned, 427 (75.2%) were decannulated, and 366 subjects (64.5%) were discharged home. The mortality rate was 6.0%. In multivariate analysis, age (odds ratio 0.30 [95% CI 0.16-0.56], P < .001), Charlson comorbidity index (odds ratio 0.43 [95% CI 0.22-0.84], P < .01), mechanical ventilation duration in ICU (odds ratio 0.80 [95% CI 0.72-0.89], P < .001), renal failure (odds ratio 0.40 [95% CI 0.22-0.73], P = .003), and expiratory muscle weakness (odds ratio 0.35 [95% CI 0.19-0.62], P < .001) were independently associated with home discharge.ConclusionsMost subjects with COVID-19 transferred to SWCs were weaned, achieved decannulation, and were discharged to home. Age, high-comorbidity burden, prolonged mechanical ventilation in ICU, renal failure at admission, and expiratory muscle weakness were inversely associated with home discharge.Copyright © 2024 by Daedalus Enterprises.

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