Lin Pu1, Bo Zhu2, Li Jiang3, Bin Du4, Xi Zhu5, Ang Li6, Gang Li7, Zhongjie He8, Wei Chen9, Penglin Ma10, Jianguo Jia11, Yuan Xu12, Jianxin Zhou13, Long Qin14, Qingyuan Zhan15, Wenxiong Li16, Qi Jiang17, Meiping Wang18, Ran Lou19, XiuMing Xi20. 1. 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. 2. Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: zhubo123123@hotmail.com. 3. Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: jianglifx@163.com. 4. Medical Intensive Care Unit, MICU Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: dubin08@163.com. 5. Department of Critical Care Medicine, ICU Peking University Third Hospital, Beijing 100191, China. Electronic address: xizhuccm@126.com. 6. Department of Critical Care Medicine, Capital Medical University, ICU Beijing Friendship Hospital, Beijing 100050, China.. Electronic address: liang_bjfh68@163.com. 7. Department of Critical Care Medicine, ICU China-Japan Friendship Hospital, Beijing 100029, China. Electronic address: ligangxdysw@163.com. 8. Department of Critical Care Medicine, ICU The First Affiliated Hospital of General Hospital of People's Liberation Army, Beijing 100048, China. Electronic address: drhezhj@163.com. 9. Department of Critical Care Medicine, Capital Medical University, ICU Beijing Shijitan Hospital, Beijing 100038, China. Electronic address: chenweihanwa@163.com. 10. Department of Critical Care Medicine, ICU The 309th Hospital of Chinese People's Liberation Army, Beijing 100094, China. Electronic address: mapenglin10@163.com. 11. Surgical Intensive Care Unit, Capital Medical University, SICU Xuan Wu Hospital, Beijing 100053, China. Electronic address: jiajianguo_1@163.com. 12. Department of Critical Care Medicine, Capital Medical University, ICU Beijing Tong Ren Hospital, Beijing 100730, China. Electronic address: xyuan76@yeah.net. 13. Department of Critical Care Medicine, Capital Medical University, ICU Beijing Tian Tan Hospital, Beijing 100050, China. Electronic address: Zhoujx.cn@icloud.com. 14. Department of Critical Care Medicine, ICU Beijing Haidian Hospital, Beijing 100080, China. Electronic address: qinlong1028@126.com. 15. Department of Respiratory, China-Japan Friendship Hospital, Beijing 100029, China. Electronic address: Zhanqy0915@126.com. 16. Surgical Intensive Care Unit, Capital Medical University, SICU Beijing Chao-Yang Hospital, Beijing 100020, China. Electronic address: lwx7115@163.com. 17. Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: jiangqi7676@126.com. 18. Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: xiaolajiao001326@163.com. 19. Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: springin12@163.com. 20. Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: xxm2937@yeah.net.
Abstract
PURPOSE: A 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. METHODS: We examined the weaning of patients in intensive care units from mechanical ventilation in a prospective multicenter cohort study. RESULTS: In 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. CONCLUSIONS: Patients 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.
PURPOSE: A 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. METHODS: We examined the weaning of patients in intensive care units from mechanical ventilation in a prospective multicenter cohort study. RESULTS: In 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. CONCLUSIONS:Patients 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.