open access

Vol 88, No 6 (2020)
Research paper
Published online: 2020-11-03
Submitted: 2020-03-11
Accepted: 2020-07-14
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Predictors of successful weaning in patients requiring extremely prolonged mechanical ventilation

Yuval Leonov, Igor Kisil, Alona Perlov, Vladimir Stoichev, Yulia Ginzburg, Alla Nazarenko, Yuri Gimelfarb
DOI: 10.5603/ARM.a2020.0151
·
Pubmed: 33393639
·
Adv Respir Med 2020;88(6):477-484.

open access

Vol 88, No 6 (2020)
ORIGINAL PAPERS
Published online: 2020-11-03
Submitted: 2020-03-11
Accepted: 2020-07-14

Abstract

Introduction: For patients on prolonged mechanical ventilation (PMV; > 21 days), successful weaning has been attributed to various factors. The aim of this study is to determine the usefulness of the rapid shallow breathing index (RSBI) and other potential predictors of successful weaning in patients unable to wean and requiring extreme PMV at a hospital-based long-term ventilator facility in Israel. Material and ethods: Retrospective analysis of prospectively collected data over 5 years. Results: A total of 150 subjects on PMV, ready to undergo a weaning process, were included in the study. Of them, 60 (40.0%) were males. The mean age of the whole study population was 76.5 years (SD = 13.6; range 22.0–96.0 years). The subjects were on MV for a mean period of 170.1 days (SD = 237.6; range 25.0–1624.0 days). Sixty patients (40%) were successfully weaned. The mean RSBI in the successfully weaned population was 41.9 breaths/min/L (SD = 12.3; range 13.0–80.4 breaths/min/L), in the population where weaning failed, it was 114.8 breaths/min/L (SD = 69.2; range 47.5–450.0 breaths/min/L). By univariate logistic regression analysis, younger age (p < 0.007), female gender (p < 0.001), decreased duration of MV (p < 0.023), re-spiratory rate (p < 0.001) and RSBI (p < 0.001), increased tidal volume/ideal body weight (p < 0.001) and minute ventilation (p < 0.01) were found to be factors that significantly predict successful weaning. By multivariate analysis, increased tidal volume/ /ideal body weight (p < 0.007) and decreased RSBI (p < 0.046) were found to be independent predictors of successful weaning (p < 0.001; R2 Nagelkerke = 0.90). Conclusions: Factors independently predicting successful weaning in patients requiring extreme PMV included increased tidal volume/ideal body weight and decreased RSBI.

Abstract

Introduction: For patients on prolonged mechanical ventilation (PMV; > 21 days), successful weaning has been attributed to various factors. The aim of this study is to determine the usefulness of the rapid shallow breathing index (RSBI) and other potential predictors of successful weaning in patients unable to wean and requiring extreme PMV at a hospital-based long-term ventilator facility in Israel. Material and ethods: Retrospective analysis of prospectively collected data over 5 years. Results: A total of 150 subjects on PMV, ready to undergo a weaning process, were included in the study. Of them, 60 (40.0%) were males. The mean age of the whole study population was 76.5 years (SD = 13.6; range 22.0–96.0 years). The subjects were on MV for a mean period of 170.1 days (SD = 237.6; range 25.0–1624.0 days). Sixty patients (40%) were successfully weaned. The mean RSBI in the successfully weaned population was 41.9 breaths/min/L (SD = 12.3; range 13.0–80.4 breaths/min/L), in the population where weaning failed, it was 114.8 breaths/min/L (SD = 69.2; range 47.5–450.0 breaths/min/L). By univariate logistic regression analysis, younger age (p < 0.007), female gender (p < 0.001), decreased duration of MV (p < 0.023), re-spiratory rate (p < 0.001) and RSBI (p < 0.001), increased tidal volume/ideal body weight (p < 0.001) and minute ventilation (p < 0.01) were found to be factors that significantly predict successful weaning. By multivariate analysis, increased tidal volume/ /ideal body weight (p < 0.007) and decreased RSBI (p < 0.046) were found to be independent predictors of successful weaning (p < 0.001; R2 Nagelkerke = 0.90). Conclusions: Factors independently predicting successful weaning in patients requiring extreme PMV included increased tidal volume/ideal body weight and decreased RSBI.

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Keywords

mechanical ventilation; respiratory mechanics; mechanical ventilator weaning; respiratory rate; tidal volume

About this article
Title

Predictors of successful weaning in patients requiring extremely prolonged mechanical ventilation

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 6 (2020)

Article type

Research paper

Pages

477-484

Published online

2020-11-03

DOI

10.5603/ARM.a2020.0151

Pubmed

33393639

Bibliographic record

Adv Respir Med 2020;88(6):477-484.

Keywords

mechanical ventilation
respiratory mechanics
mechanical ventilator weaning
respiratory rate
tidal volume

Authors

Yuval Leonov
Igor Kisil
Alona Perlov
Vladimir Stoichev
Yulia Ginzburg
Alla Nazarenko
Yuri Gimelfarb

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