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June 6, 2026Critical CareOpen Access

Integrated comprehensive assessment for predicting weaning success in difficult-to-wean critically ill patients: the WEAN-US study

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Authors

AFAlberto FogagnoloMDMartin DresFMFrancesco Murgolo

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Overview

Prospective observational study assesses weaning outcomes in critically ill patients using multimodal ultrasound assessment, indicating improved prediction efficacy.

Key Points

  • The study aims to evaluate whether a comprehensive ultrasound-based assessment during spontaneous breathing trials can better predict weaning outcomes in difficult-to-wean patients.
  • Single-center prospective observational study of adult difficult-to-wean patients (≥ 48 h of mechanical ventilation).
  • Conducted standardized spontaneous breathing trials assessing diaphragmatic, pulmonary, cardiac, and neuromuscular functions.
  • Developed an integrated predictive model using clinical selection and LASSO regression.
  • Weaning failure occurred in 27% of patients, associated with lower diaphragmatic contractile reserve and reduced muscle strength.
  • The integrated model demonstrated good predictive performance (AUROC 0.88; 95% CI 0.78–0.95) compared to individual predictors.
  • SBT failure linked to higher E/e' ratio and impaired cardiac parameters, with neuromuscular issues more closely related to post-extubation failure.

Cite This Study

Fogagnolo et al. (2026) studied this question.

synapsesocial.com/papers/6a23bb4471a5da9775e76ccfhttps://doi.org/10.1186/s13054-026-06113-7
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