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Journal of critical care · Aug 2015
Weaning critically ill patients from mechanical ventilation: A prospective cohort study.
- Lin Pu, Bo Zhu, Li Jiang, Bin Du, Xi Zhu, Ang Li, Gang Li, Zhongjie He, Wei Chen, Penglin Ma, Jianguo Jia, Yuan Xu, Jianxin Zhou, Long Qin, Qingyuan Zhan, Wenxiong Li, Qi Jiang, Meiping Wang, Ran Lou, and XiuMing Xi.
- Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China; Department of Critical Care Medicine, Capital Medical University, ICU Beijing Ditan Hospital, Beijing 100015, China. Electronic address: pulin1103@163.com.
- J Crit Care. 2015 Aug 1;30(4):862.e7-13.
PurposeA proposal was made at the International Consensus Conference to classify weaning of patients in intensive care units from mechanical ventilation into simple, difficult, and prolonged weaning groups based on the difficulty and length of the weaning process. The objective of the present study was to determine the incidence and outcome of weaning according to these new categories.MethodsWe examined the weaning of patients in intensive care units from mechanical ventilation in a prospective multicenter cohort study.ResultsIn total, 343 patients were included in the final analysis. Simple, difficult, and prolonged weaning occurred in 200 (58%), 99 (29%), and 44 (13%) patients, respectively. Hospital mortality rates were higher for patients in the prolonged weaning group than in the simple and difficult weaning groups. Multivariate analysis revealed that a lower Glasgow Coma Scale score (P < .014) and hypercapnia at the beginning of the first spontaneous breathing trial (P = .038) were independent predictors of prolonged weaning.ConclusionsPatients who experienced prolonged weaning had significantly higher mortality rates than patients who experienced either simple or difficult weaning. A lower Glasgow Coma Scale score and hypercapnia at the beginning of the weaning process were independent risk factors for prolonged weaning.Copyright © 2015 Elsevier Inc. All rights reserved.
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