Table 4.
Studies identifying risk factors for weaning failure
| First author | Patients | ICU setting | Weaning failure Pts. (%) | Risk factors |
|---|---|---|---|---|
| Ghiani et al. [31] | Pts. with prolonged weaning | Specialized weaning center | 137 (52) | Female gender, BMI ≥30 kg/m2, mechanical power normalized to dynamic compliance of the respiratory system PaCO2 on MV |
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| Huang et al. [32] | Respiratory care center (RCC) pts. | RCC | 83 (14.4) | Cause of the respiratory failure that lead to MV |
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| Li et al. [39] | ICU Pts. on MV | 55 ICUs | 147 (48.7) | Age >74 years, COPD |
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| Magnet et al. [6] | Pts. treated in specialized weaning center receiving MV via tracheostomy | 64 (51.6) | PaCO2 >45 mm Hg after the first SBT Intubation >30 days Long-term HMV prior to current weaning episode |
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| Muzaffa et al. [35] | Pts. requiring MV ≥21 days, 6 h/day | 12-bed medical and surgical ICU | 15 (30.6) | Duration of vasopressor support hemodialysis |
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| Saiphoklang et al. [36] | Pts. requiring MV | 17 (16.5) | Bronchospasm, pneumonia, malnutrition | |
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| Tseng et al. [37] | Non-HF patients admitted to ICU for intensive critical care and ventilator weaning | 35-bed MICU | 72 (25.2) | Atrial fibrillation on intensive care unit admission |
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| Windisch et al. [7] | Pts. transferred to specialized weaning centers | Specialized weaning centers | 2420 (21.2) | Reasons for MV; acute exacerbation of COPD or acute on chronic worsening of neuromuscular disease, older age, low BMI, prolonged duration of invasive ventilation prior to transfer to weaning center, ECOG performance status. Preexisting long-term NIV, COPD, restrictive thoracic disease, NMD, arterial hypertension |
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| Wu et al. [38] | Stable ventilated pts., MV >21 days and failed weaning attempts | 24-bed RCC | 571 (43.7) | RCC length of stay, APACHE-II, Pimax, Albumin, BUN (within 24 h of admission) |
The table shows the studies that examine the risk factors for weaning failure. PaCO2, partial pressure of carbon dioxide; RCC, respiratory care center; HF, heart failure; BMI, body mass index; HMV, home mechanical ventilation; MV, mechanical ventilation; SBT, spontaneous breathing trial; ICU, intensive care unit; ECOG, Eastern Cooperative Oncology Group; NMD, neuromuscular disorder; COPD, chronic obstructive pulmonary disease; APACHE-II, Acute Physiology and Chronic Health; Pimax peak inspiratory maximum pressure; BUN, Blood Urea Nitrogen; MICU, MICU, medical intensive care unit.