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- Open Access
Prognosis of mechanically ventilated patients entering the weaning process
© Beduneau et al.; 2015
- Published: 1 October 2015
- Public Health
- Intensive Care Unit
- Observational Study
- Mechanical Ventilation
- Large Cohort
The WIND study “Weaning according to New Definition " prospectively collected epidemiologic data concerning mechanical ventilation (MV) and weaning. The aim of the present analysis was to specifically address mortality at the different pre-defined steps of the weaning process.
This is a subsequent analysis of the original prospective observational study run in 36 intensive care units in France, Spain and Switzerland over a three month period. All patients requiring intubation and MV were enrolled. MV modality, results of spontaneous breathing trials (SBT) and extubation, therapeutic limitation as well as survival were daily collected until ICU discharge or day 60. A weaning attempt (WA) was defined either by a spontaneous breathing trial or a direct extubation (planned or unplanned). Weaning success was defined as discharged alive without mechanical ventilation within the 7 days following extubation. The prognosis of patients at the key steps of the weaning process was analysed as mortality at ICU discharge or D60.
After failure of 1st WA, 125 patients (among the 197 dead) died in the seven first days.
Entering weaning (WA)
Failure 1st WA
Still ventilated 7 days after 1st WA
Mortality, % (N)
Based on this large cohort of intubated patients, mortality was 10% for the patients entering the weaning process but was three times higher (33%) in patients failing their 1st WA; 63% of the deaths occurred within one week after the failed WA. The present analysis is the first to document mortality along different steps of the weaning process as experienced in daily practice.
Association d’aide aux insuffisants respiratoires (Rouen, France)
*GB and TP are considered both as first authors.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.