• Jung-Rern Jiang, Shiao-Yu Yen, Jung-Yien Chien, Hsiao-Chien Liu, Yi-Ling Wu, and Ching-Hui Chen.
• Department of Internal Medicine, St Joseph's Hospital, Yunlin County, Taiwan.
• Respirology. 2014 May 1;19(4):576-82.

Background And ObjectiveA number of clinical factors play pivotal roles in weaning and successful extubation of patients requiring long-term mechanical ventilator (LTMV) support. Many patients fail extubation even after passing weaning protocols and spontaneous breathing trials. This study aimed to assess the effectiveness of using a modified Burns Wean Assessment Program (m-BWAP) scoring instrument to predict extubation outcome in patients requiring LTMV.MethodsAll patients with a diagnostic coding for respiratory failure requiring LTMV for longer than 21 days over a 5-year period in a single centre (total 527 patients) were included. Advanced practice nurses trained in the use of the m-BWAP scored the items according to standard definitions. All patients were weaned by pressure support weaning and spontaneous breathing trails. Patients were divided into successful and unsuccessful groups according to the weaning and extubation outcomes. Baseline data, traditional weaning parameters and m-BWAP of the groups were analysed. The sensitivity and specificity of m-BWAP for predicting successful extubation were calculated.ResultsOf the 527 patients included, 145 (27.5%) had successful weaning trials. Of the 130 patients extubated, 102 (78.5%) had successful extubation. The m-BWAP score was higher in the patients with successful weaning trials and successful extubation outcome. Using a cut-off value of 60, the sensitivity and specificity of the m-BWAP to predict successful extubation were 81.4% and 82.1%, respectively. This was better than traditional weaning parameters.ConclusionsThe m-BWAP is a good predictor for weaning and extubation outcome in patients requiring LTMV for longer than 21 days.© 2014 Asian Pacific Society of Respirology.

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