The Risk Factors for Weaning Failure of Mechanically Ventilated Patients With COVID-19: A Retrospective Study in National Medical Team Work

Zhao, Hua; Su, Longxiang; Ding, Xin; Chen, Huan; Zhang, Hongmin; Wang, Jinglan; Long, Yun; Zhou, Xiang; Zhang, Shuyang

doi:10.3389/fmed.2021.678157

Cited by 6 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Weaning failure results in longer duration of MV and longer ICU stay which both are associated with adverse outcome. Zhao et al, [ 40 ] reported also a significant association between the weaning outcome and the 28 th day mortality in SARS-CoV2 patients.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Weaning Failure in COVID-19 Patients

Gerovasileiou,

Menis,

Gavriilidis

et al. 2023

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

Background Data on risk factors associated with mechanical ventilation (MV) weaning failure among SARS-CoV2 ARDS patients is limited. We aimed to determine clinical characteristics associated with weaning outcome in SARS-CoV2 ARDS patients under MV. Objectives To determine potential risk factors for weaning outcome in patients with SARS-CoV2 ARDS. Methods A retrospective observational study was conducted in the ICUs of four Greek hospitals via review of the electronic medical record for the period 2020–2021. All consecutive adult patients were screened and were included if they fulfilled the following criteria: a) age equal or above 18 years, b) need for MV for more than 48 hours and c) diagnosis of ARDS due to SARS-CoV2 pneumonia or primary or secondary ARDS of other aetiologies. Patient demographic and clinical characteristics were recorded for the first 28 days following ICU admission. The primary outcome was weaning success defined as spontaneous ventilation for more than 48 hours. Results A hundred and fifty eight patients were included; 96 SARS-CoV2 ARDS patients. SOFA score, Chronic Obstructive Pulmonary Disease (COPD) and shock were independently associated with the weaning outcome OR(95% CI), 0.86 (0.73–0.99), 0.27 (0.08–0.89) and 0.30 (0.14–0.61), respectively]. When we analysed data from SARS-CoV2 ARDS patients separately, COPD [0.18 (0.03–0.96)] and shock [0.33(0.12 – 0.86)] were independently associated with the weaning outcome. Conclusions The presence of COPD and shock are potential risk factors for adverse weaning outcome in SARS-CoV2 ARDS patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Weaning Failure in COVID-19 Patients

Gerovasileiou,

Menis,

Gavriilidis

et al. 2023

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…In this study, a low PEEP strategy was found to be more beneficial for patients with sepsis weaning from ventilation. Although the low-level PEEP strategy did not have a significant effect on improving ventilator weaning in a cohort study ( 28 ), it still has the potential to promote ventilator weaning ( 29 ). There is increasing evidence that high levels of PEEP are a risk factor in reducing the likelihood of WS ( 19 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

A Simple Weaning Model Based on Interpretable Machine Learning Algorithm for Patients With Sepsis: A Research of MIMIC-IV and eICU Databases

et al. 2022

View full text Add to dashboard Cite

BackgroundInvasive mechanical ventilation plays an important role in the prognosis of patients with sepsis. However, there are, currently, no tools specifically designed to assess weaning from invasive mechanical ventilation in patients with sepsis. The aim of our study was to develop a practical model to predict weaning in patients with sepsis.MethodsWe extracted patient information from the Medical Information Mart for Intensive Care Database-IV (MIMIC-IV) and the eICU Collaborative Research Database (eICU-CRD). Kaplan–Meier curves were plotted to compare the 28-day mortality between patients who successfully weaned and those who failed to wean. Subsequently, MIMIC-IV was divided into a training set and an internal verification set, and the eICU-CRD was designated as the external verification set. We selected the best model to simplify the internal and external validation sets based on the performance of the model.ResultsA total of 5020 and 7081 sepsis patients with invasive mechanical ventilation in MIMIC-IV and eICU-CRD were included, respectively. After matching, weaning was independently associated with 28-day mortality and length of ICU stay (p < 0.001 and p = 0.002, respectively). After comparison, 35 clinical variables were extracted to build weaning models. XGBoost performed the best discrimination among the models in the internal and external validation sets (AUROC: 0.80 and 0.86, respectively). Finally, a simplified model was developed based on XGBoost, which included only four variables. The simplified model also had good predictive performance (AUROC:0.75 and 0.78 in internal and external validation sets, respectively) and was developed into a web-based tool for further review.ConclusionsWeaning success is independently related to short-term mortality in patients with sepsis. The simplified model based on the XGBoost algorithm provides good predictive performance and great clinical applicablity for weaning, and a web-based tool was developed for better clinical application.

show abstract

“…The diagnosis of the patient's preparedness for weaning is one of the important tasks that nurses perform in the ICU. Effective weaning features include better weaning preparation interventions, regular weaning readiness assessments, techniques to enhance and encourage spontaneous breathing during weaning, and the use of spontaneous breathing trials (SBT) to gauge the likelihood of weaning the patient from the ventilator [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Prolonged mechanical ventilation and the uncertainty surrounding weaning can lead to psychological distress, moreover patients experiencing high levels of stress or anxiety may require a longer time on the ventilator, leading to increased healthcare costs and potential complications associated with prolonged mechanical ventilation. The psychosocial predictors of ventilator weaning outcomes in patients have not been systematically evaluated [ 7 ].…”

Section: Introductionmentioning

confidence: 99%