A proposal of a new model for long-term weaning: Respiratory intensive care unit and weaning center

Carpenè, Nicoletta; Vagheggini, Guido; Panait, Eugenia; Gabbrielli, Luciano; Ambrosino, Nicolino

doi:10.1016/j.rmed.2010.05.012

Cited by 48 publications

(50 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are also respiratory intermediate care units (RICU) and specialized regional weaning centers (WCs) available to patients who require additional care. The sequential admission to RICU and WCs can further improve the weaning success rate of difficult-to-wean patients (33). Unfortunately, our hospital does not offer the services associated with LTAC, RICU or WCs.…”

Section: Discussionmentioning

confidence: 99%

Clinical factors associated with weaning failure in patients requiring prolonged mechanical ventilation

Shin¹,

Chang²,

Ahn³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). Results: Among the 127 patients requiring PMV, 41 (32.3%) were successfully weaned from MV. The median age of the weaning failure group was higher than that of the weaning success group (74.0 vs. 70.0 years; P=0.003). The proportion of male patients was 58.5% in the weaning success group and 72.1% in the weaning failure group, respectively. The most common reasons for ICU admission were respiratory causes (66.1%) followed by cardiovascular causes (16.5%) in both groups. ICU mortality and in-hospital mortality rates were 55.1% and 55.9%, respectively. In the multivariate analysis, respiratory causes of ICU admission [odds ratio (OR), 3.98; 95% confidence interval (CI), 1.29-12.30; P=0.016] and a high sequential organ failure assessment (SOFA) score on day 21 of MV (OR, 1.47; 95% CI, P=0.001) were significantly associated with weaning failure in patients requiring PMV. The area under the receiver operating characteristic (ROC) curve of the SOFA score on day 21 of MV for predicting weaning failure was 0.77 (95% CI, 0.67-0.87; P=0.000).Conclusions: Respiratory causes of ICU admission and a high SOFA score on day 21 of MV could be predictive of weaning failure in patients requiring PMV.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical factors associated with weaning failure in patients requiring prolonged mechanical ventilation

Shin¹,

Chang²,

Ahn³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…28 The advantages of a new model for long-term weaning, based on the integrated activity of one Italian RHDCU and one weaning center run by the same pulmonology team, were recently described. 29 We speculate that the changes in the pattern of diseases admitted to RHDCUs may be the result of 3 factors:…”

Section: Interventions Diseases and Outcomesmentioning

confidence: 97%

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Scala¹,

Corrado

Confalonieri

et al. 2011

Respir Care

View full text Add to dashboard Cite

.03), and the physician-to-patient mean ratio and the nurse-to-patient mean ratio per shift were lower (P ‫؍‬ .001 and P ‫؍‬ .002, respectively). Admissions for only monitoring decreased (P < .001), and admissions for active interventions increased: noninvasive ventilation (P ‫؍‬ .002), invasive ventilation (P < .001), weaning from invasive ventilation (P < .001), and tracheal decannulation (P < .001). The complexity of RHDCU patients' conditions increased: there was a reduction in the percentage of COPD patients (P < .001) and an increase in the percentage of patients with neuromyopathies (P < .001) and de novo hypoxemia (P ‫؍‬ .006). CONCLUSIONS: Between 1997 and 2007 there was an increase in the number and expertise of Italian RHDCUs, with a shift toward less expensive care, and greater complexity of interventions and patient dysfunctions. These findings support the crucial role of RHDCUs in the management of respiratory critical patients.

show abstract

“…Patients will also enjoy a higher level of intimacy and privacy than at the ICU. 6,7 These kind of units have demonstrated good results in other diseases 8 in terms of utilization of resources, mortality, successful weaning rates and reintegration into the community, as well as saving costs. Some experiences in SCI patients have shown promising results.…”

Section: Introductionmentioning

confidence: 99%

An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study

Romero-Ganuza¹,

García-Forcada²,

Vargas

et al. 2015

Spinal Cord

View full text Add to dashboard Cite

A proposal of a new model for long-term weaning: Respiratory intensive care unit and weaning center

Abstract: The sequential activity of a RICU and a WC resulted in additive weaning success rate of difficult-to wean patients. The cost-benefit ratio of the program warrants prospective investigations.

Cited by 48 publications

References 37 publications

Clinical factors associated with weaning failure in patients requiring prolonged mechanical ventilation

Clinical factors associated with weaning failure in patients requiring prolonged mechanical ventilation

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study

Contact Info

Product

Resources

About