BACKGROUND: Weaning from invasive mechanical ventilation (IMV) in specialized weaning units has been demonstrated to be safe and cost-effective. Success rates and outcomes vary widely, probably relating to patient factors and unit expertise. METHODS: An audit was undertaken of patients admitted for weaning from IMV at the Austin Hospital Ventilation Weaning Unit (VWU) between March 2002 and January 2008. Weaning success, complications and both in-hospital and long-term mortality were examined and regression analysis was undertaken to examine factors related to these outcomes. RESULTS: Seventy-eight patients were admitted to the VWU after a median of 27 days of IMV at their referring centre. Weaning success rate (ventilator free or nocturnal non-invasive ventilation only) was 78.2% (n = 61). Inpatient mortality was 10.2% (n = 8) and serious complications were infrequent. Progressive neuromuscular disease (odds ratio 0.10) and sepsis during admission to the VWU (odds ratio 0.09) were predictive of weaning failure at discharge. Overall survival at 12 months following discharge from the VWU was 66.7% (n = 52) with most survivors residing in the community. Increasing age (hazard ratio 1.93), referral from rural or outer metropolitan centres (hazard ratio 3.57 and 2.37 respectively) and a diagnosis of chronic obstructive pulmonary disease were associated with increased long-term mortality. CONCLUSION: High rates of weaning success with infrequent complications and low mortality were achieved in this specialized non-intensive care unit-based weaning unit. The VWU may provide a useful template for the development of similar units elsewhere.
BACKGROUND: Weaning from invasive mechanical ventilation (IMV) in specialized weaning units has been demonstrated to be safe and cost-effective. Success rates and outcomes vary widely, probably relating to patient factors and unit expertise. METHODS: An audit was undertaken of patients admitted for weaning from IMV at the Austin Hospital Ventilation Weaning Unit (VWU) between March 2002 and January 2008. Weaning success, complications and both in-hospital and long-term mortality were examined and regression analysis was undertaken to examine factors related to these outcomes. RESULTS: Seventy-eight patients were admitted to the VWU after a median of 27 days of IMV at their referring centre. Weaning success rate (ventilator free or nocturnal non-invasive ventilation only) was 78.2% (n = 61). Inpatient mortality was 10.2% (n = 8) and serious complications were infrequent. Progressive neuromuscular disease (odds ratio 0.10) and sepsis during admission to the VWU (odds ratio 0.09) were predictive of weaning failure at discharge. Overall survival at 12 months following discharge from the VWU was 66.7% (n = 52) with most survivors residing in the community. Increasing age (hazard ratio 1.93), referral from rural or outer metropolitan centres (hazard ratio 3.57 and 2.37 respectively) and a diagnosis of chronic obstructive pulmonary disease were associated with increased long-term mortality. CONCLUSION: High rates of weaning success with infrequent complications and low mortality were achieved in this specialized non-intensive care unit-based weaning unit. The VWU may provide a useful template for the development of similar units elsewhere.
Authors: Louise Rose; Douglas McKim; Sherri Katz; David Leasa; Mika Nonoyama; Cheryl Pedersen; Monica Avendano; Roger Goldstein Journal: Can Respir J Date: 2014-09-03 Impact factor: 2.409
Authors: Carmen Sílvia Valente Barbas; Alexandre Marini Ísola; Augusto Manoel de Carvalho Farias; Alexandre Biasi Cavalcanti; Ana Maria Casati Gama; Antonio Carlos Magalhães Duarte; Arthur Vianna; Ary Serpa Neto; Bruno de Arruda Bravim; Bruno do Valle Pinheiro; Bruno Franco Mazza; Carlos Roberto Ribeiro de Carvalho; Carlos Toufen Júnior; Cid Marcos Nascimento David; Corine Taniguchi; Débora Dutra da Silveira Mazza; Desanka Dragosavac; Diogo Oliveira Toledo; Eduardo Leite Costa; Eliana Bernadete Caser; Eliezer Silva; Fabio Ferreira Amorim; Felipe Saddy; Filomena Regina Barbosa Gomes Galas; Gisele Sampaio Silva; Gustavo Faissol Janot de Matos; João Claudio Emmerich; Jorge Luis dos Santos Valiatti; José Mario Meira Teles; Josué Almeida Victorino; Juliana Carvalho Ferreira; Luciana Passuello do Vale Prodomo; Ludhmila Abrahão Hajjar; Luiz Claudio Martins; Luis Marcelo Sá Malbouisson; Mara Ambrosina de Oliveira Vargas; Marco Antonio Soares Reis; Marcelo Brito Passos Amato; Marcelo Alcântara Holanda; Marcelo Park; Marcia Jacomelli; Marcos Tavares; Marta Cristina Paulette Damasceno; Murillo Santucci César Assunção; Moyzes Pinto Coelho Duarte Damasceno; Nazah Cherif Mohamed Youssef; Paulo José Zimmermann Teixeira; Pedro Caruso; Péricles Almeida Delfino Duarte; Octavio Messeder; Raquel Caserta Eid; Ricardo Goulart Rodrigues; Rodrigo Francisco de Jesus; Ronaldo Adib Kairalla; Sandra Justino; Sergio Nogueira Nemer; Simone Barbosa Romero; Verônica Moreira Amado Journal: Rev Bras Ter Intensiva Date: 2014 Jul-Sep
Authors: Jesus Sancho; Emilio Servera; Luis Jara-Palomares; Emilia Barrot; Raquel Sanchez-Oro-Gómez; F Javier Gómez de Terreros; M Jesús Martín-Vicente; Isabel Utrabo; M Belen Núñez; Alicia Binimelis; Ernest Sala; Enrique Zamora; Gonzalo Segrelles; Angel Ortega-Gonzalez; Fernando Masa Journal: ERJ Open Res Date: 2016-10-28
Authors: Denise Mifsud Bonnici; Thomas Sanctuary; Alex Warren; Patrick B Murphy; Joerg Steier; Philip Marino; Hina Pattani; Ben C Creagh-Brown; Nicholas Hart Journal: BMJ Open Date: 2016-03-08 Impact factor: 2.692
Authors: Stephanie M Sison; Gayathri K Sivakumar; Christine Caufield-Noll; William B Greenough; Esther S Oh; Panagis Galiatsatos Journal: Heliyon Date: 2021-02-13