Incidence and outcome of weaning from mechanical ventilation according to new categories
Autor: | R. Kohansal, Heindl W, Georg-Christian Funk, Hinterholzer G, Anders S, Schuster R, Valentin A, M.K. Breyer, Edelmann G, Otto-Chris Burghuber, Schwarzmaier-D'Assie A, Sylvia Hartl |
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Rok vydání: | 2009 |
Předmět: |
Male
Pulmonary and Respiratory Medicine Artificial ventilation Pediatrics medicine.medical_specialty Time Factors medicine.medical_treatment law.invention law medicine Humans Weaning Prospective Studies Prospective cohort study Mechanical ventilation business.industry Incidence Incidence (epidemiology) Middle Aged Intensive care unit Treatment Outcome Cohort Female business Ventilator Weaning Cohort study |
Zdroj: | European Respiratory Journal. 35:88-94 |
ISSN: | 1399-3003 0903-1936 |
DOI: | 10.1183/09031936.00056909 |
Popis: | Weaning from mechanical ventilation was categorised as simple, difficult or prolonged by an international task force of the American Thoracic Society/European Respiratory Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine/Sociéte de Réanimation de Langue Française in 2007. This new classification has not been tested in clinical practice. The objective of the present study was to determine the incidence and outcome of weaning according to the new categories. We included medical and surgical patients who required mechanical ventilation in a prospective, multicentre, 6-month cohort study. From an initial cohort of 510 patients, 257 intubated patients started weaning. Of these patients, the cumulative incidences of simple, difficult, and prolonged weaning were 152 (59%), 68 (26%) and 37 (14%), respectively. Hospital mortality was increased in patients with prolonged (32%) but not difficult (9%) weaning in comparison with those with simple weaning (13%), overall p = 0.0205. In a multivariate logistic regression model, prolonged but not difficult weaning was associated with an increased risk of death. Ventilator-free days and intensive care unit (ICU)-free days were decreased in both difficult and prolonged weaning. In conclusion, the new weaning category prolonged weaning is associated with increased mortality and morbidity in the ICU. The new category difficult to wean was associated with increased morbidity, but not mortality. |
Databáze: | OpenAIRE |
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