• Sebastian Johannes Fritsch, Morris Riedel, Gernot Marx, Johannes Bickenbach, and Andreas Schuppert.
• Jülich Supercomputing Centre, Forschungszentrum Jülich, 52428 Jülich, Germany; Department of Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; Center for Advanced Simulation and Analytics (CASA), Forschungszentrum Jülich, 52428 Jülich, Germany. Electronic address: s.fritsch@fz-juelich.de.
• J Crit Care. 2024 Aug 1; 82: 154795154795.

PurposeTreatment of patients undergoing prolonged weaning from mechanical ventilation includes repeated spontaneous breathing trials (SBTs) without respiratory support, whose duration must be balanced critically to prevent over- and underload of respiratory musculature. This study aimed to develop a machine learning model to predict the duration of unassisted spontaneous breathing.Materials And MethodsStructured clinical data of patients from a specialized weaning unit were used to develop (1) a classifier model to qualitatively predict an increase of duration, (2) a regressor model to quantitatively predict the precise duration of SBTs on the next day, and (3) the duration difference between the current and following day. 61 features, known to influence weaning, were included into a Histogram-based gradient boosting model. The models were trained and evaluated using separated data sets.Results18.948 patient-days from 1018 individual patients were included. The classifier model yielded an ROC-AUC of 0.713. The regressor models displayed a mean absolute error of 2:50 h for prediction of absolute durations and 2:47 h for day-to-day difference.ConclusionsThe developed machine learning model showed informed results when predicting the spontaneous breathing capacity of a patient in prolonged weaning, however lacking prognostic quality required for direct translation to clinical use.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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