Identification of factors predicting successful weaning from critically ill mechanically ventilated patients

Background: Critically ill patients often require prolonged weaning from invasive mechanical ventilation (MV). The factors associated with successful weaning in ICU patients are still debated Aim: Identification of the most significant factors associated with successful weaning from MV in critically ill patients with >3 days in the ICU Methods: A prospective observational study was conducted in a large ICU, recording parameters concerning patient demographics, severity scores (APACHE II and SOFA) and metrics at the initiation of weaning, before /after extubation (Heart – Respiratory rate, blood gases, lung ultrasound score [LUS], Rapid Shallow Breathing Index [RSBI], Maximum Inspiratory Pressure [MIP], ICU Length of stay, MV duration, Glasgow Coma Scale [GCS] & indicators of respiratory function after extubation [management of secretions, cough, use of accessory muscles, dyspnea]). Comparison of means using t-test or Mann-Whitney (for variables with or without normal distribution) and x2 test for correlations between categorical variables were utilized Results: 26 patients (17 male) with mean age 63.3 years, 9.3 days under MV, APACHE score 18.8, were included. Factors associated with successful weaning were: Initial heart/respiratory rate, abdominal breathing & secretions management. RSBI almost reached statistical significance (p=0.057) Conclusions: Lower heart/respiratory rate at the beginning of the weaning process, lower RSBI, absence of abdominal breathing post-extubation and better secretions management by patients seem to predict successful weaning from invasive MV. Further research in a larger sample of critically ill patients will clarify the most important indicators