Predictors of survival after prolonged weaning from mechanical ventilation
Weaning from mechanical ventilation is a key component of intensive care treatment; however, this process may be prolonged as some patients require care at specialised centres. Current data indicate that weaning from invasive mechanical ventilation is successful in approximately 65% of patients; how...
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| Veröffentlicht in: | Journal of critical care 2020-12, Vol.60, p.212-217 |
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| creator | Warnke, Christian Heine, Alexander Müller-Heinrich, Annegret Knaak, Christine Friesecke, Sigrun Obst, Anne Bollmann, Tom Desole, Susanna Boesche, Michael Stubbe, Beate Ewert, Ralf |
| description | Weaning from mechanical ventilation is a key component of intensive care treatment; however, this process may be prolonged as some patients require care at specialised centres. Current data indicate that weaning from invasive mechanical ventilation is successful in approximately 65% of patients; however, data on long-term survival after discharge from a weaning centre are limited.
We analysed predictors of survival among 597 patients (392 men, mean age 68 ± 11) post-discharge from a specialised German weaning centre.
Complete weaning from mechanical ventilation was achieved in 407 (57.8%) patients, and 106 patients (15.1%) were discharged with non-invasive ventilation; thus, prolonged weaning was successful in 72.9% of the patients. The one-year and five-year survival rates post-discharge were 66.5% and 37.1%, respectively. Age, duration of mechanical ventilation, certain clusters of comorbidities, and discharged with mechanical ventilation significantly influenced survival (p |
| doi_str_mv | 10.1016/j.jcrc.2020.08.010 |
| format | Article |
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We analysed predictors of survival among 597 patients (392 men, mean age 68 ± 11) post-discharge from a specialised German weaning centre.
Complete weaning from mechanical ventilation was achieved in 407 (57.8%) patients, and 106 patients (15.1%) were discharged with non-invasive ventilation; thus, prolonged weaning was successful in 72.9% of the patients. The one-year and five-year survival rates post-discharge were 66.5% and 37.1%, respectively. Age, duration of mechanical ventilation, certain clusters of comorbidities, and discharged with mechanical ventilation significantly influenced survival (p < .001). Completely weaned patients who were discharged with a tracheostomy had a significantly reduced survival rate than did those who were completely weaned and discharged with a closed tracheostomy (p = .004).
The identified predictors of survival after prolonged weaning could support therapeutic strategies during patients' intensive care unit stay. Patients should be closely monitored after discharge from a weaning centre.
•Data on long-term survival post-discharge from a weaning centre are limited.•We analysed predictors of survival among 597 patients from a German weaning centre.•Prolonged weaning was successful in 72.9% of the patients.•The 1- and 5-year survival rates post-discharge were 66.5% and 37.1%, respectively.•Age, ventilation duration, and some comorbidities significantly influenced survival.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2020.08.010</identifier><identifier>PMID: 32871419</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Catecholamines ; Chronic obstructive pulmonary disease ; Extubation ; Heart failure ; Hospitals ; Intensive care ; Mechanical ventilation ; Patients ; Pneumonia ; Post traumatic stress disorder ; Sepsis ; Survival ; Tracheostomy ; Ventilation ; Ventilators ; Weaning</subject><ispartof>Journal of critical care, 2020-12, Vol.60, p.212-217</ispartof><rights>2020</rights><rights>Copyright © 2020. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Dec 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-a1f42f574a2d988243513043b4f9a217a7aba9bf98e11ee0a23d3d2af31d28683</citedby><cites>FETCH-LOGICAL-c384t-a1f42f574a2d988243513043b4f9a217a7aba9bf98e11ee0a23d3d2af31d28683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2467835415?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978,64366,64368,64370,72220</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32871419$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Warnke, Christian</creatorcontrib><creatorcontrib>Heine, Alexander</creatorcontrib><creatorcontrib>Müller-Heinrich, Annegret</creatorcontrib><creatorcontrib>Knaak, Christine</creatorcontrib><creatorcontrib>Friesecke, Sigrun</creatorcontrib><creatorcontrib>Obst, Anne</creatorcontrib><creatorcontrib>Bollmann, Tom</creatorcontrib><creatorcontrib>Desole, Susanna</creatorcontrib><creatorcontrib>Boesche, Michael</creatorcontrib><creatorcontrib>Stubbe, Beate</creatorcontrib><creatorcontrib>Ewert, Ralf</creatorcontrib><title>Predictors of survival after prolonged weaning from mechanical ventilation</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Weaning from mechanical ventilation is a key component of intensive care treatment; however, this process may be prolonged as some patients require care at specialised centres. Current data indicate that weaning from invasive mechanical ventilation is successful in approximately 65% of patients; however, data on long-term survival after discharge from a weaning centre are limited.
We analysed predictors of survival among 597 patients (392 men, mean age 68 ± 11) post-discharge from a specialised German weaning centre.
Complete weaning from mechanical ventilation was achieved in 407 (57.8%) patients, and 106 patients (15.1%) were discharged with non-invasive ventilation; thus, prolonged weaning was successful in 72.9% of the patients. The one-year and five-year survival rates post-discharge were 66.5% and 37.1%, respectively. Age, duration of mechanical ventilation, certain clusters of comorbidities, and discharged with mechanical ventilation significantly influenced survival (p < .001). Completely weaned patients who were discharged with a tracheostomy had a significantly reduced survival rate than did those who were completely weaned and discharged with a closed tracheostomy (p = .004).
The identified predictors of survival after prolonged weaning could support therapeutic strategies during patients' intensive care unit stay. Patients should be closely monitored after discharge from a weaning centre.
•Data on long-term survival post-discharge from a weaning centre are limited.•We analysed predictors of survival among 597 patients from a German weaning centre.•Prolonged weaning was successful in 72.9% of the patients.•The 1- and 5-year survival rates post-discharge were 66.5% and 37.1%, respectively.•Age, ventilation duration, and some comorbidities significantly influenced survival.</description><subject>Age</subject><subject>Catecholamines</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Extubation</subject><subject>Heart failure</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Mechanical ventilation</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Post traumatic stress disorder</subject><subject>Sepsis</subject><subject>Survival</subject><subject>Tracheostomy</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Weaning</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kMFq3DAURUVJ6Eym_YEsgiGbbuzoSbItQzdlSJOGgXaRrIVGfprI2NZUsif076thki6y6Orx4NzL5RByCbQACtVNV3QmmIJRRgsqCwr0A1lCWda5rKA8I0sqJc8bIWBBLmLsKIWa8_IjWXAmaxDQLMnDr4CtM5MPMfM2i3M4uIPuM20nDNk--N6PO2yzF9SjG3eZDX7IBjTP6TWJO-A4uV5Pzo-fyLnVfcTPr3dFnr7fPq7v883Pux_rb5vccCmmXIMVzJa10KxtpGSCl8Cp4FthG82g1rXe6mZrG4kAiFQz3vKWacuhZbKSfEW-nHrTut8zxkkNLhrsez2in6NKjU3FOPA6odfv0M7PYUzrElXVkpcCykSxE2WCjzGgVfvgBh3-KKDqaFp16mhaHU0rKlUynUJXr9XzdsD2X-RNbQK-ngBMLg4Og4rG4WiS7oBmUq13_-v_C_YijqE</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Warnke, Christian</creator><creator>Heine, Alexander</creator><creator>Müller-Heinrich, Annegret</creator><creator>Knaak, Christine</creator><creator>Friesecke, Sigrun</creator><creator>Obst, Anne</creator><creator>Bollmann, Tom</creator><creator>Desole, Susanna</creator><creator>Boesche, Michael</creator><creator>Stubbe, Beate</creator><creator>Ewert, Ralf</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202012</creationdate><title>Predictors of survival after prolonged weaning from mechanical ventilation</title><author>Warnke, Christian ; Heine, Alexander ; Müller-Heinrich, Annegret ; Knaak, Christine ; Friesecke, Sigrun ; Obst, Anne ; Bollmann, Tom ; Desole, Susanna ; Boesche, Michael ; Stubbe, Beate ; Ewert, Ralf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-a1f42f574a2d988243513043b4f9a217a7aba9bf98e11ee0a23d3d2af31d28683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Catecholamines</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Extubation</topic><topic>Heart failure</topic><topic>Hospitals</topic><topic>Intensive care</topic><topic>Mechanical ventilation</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Post traumatic stress disorder</topic><topic>Sepsis</topic><topic>Survival</topic><topic>Tracheostomy</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Warnke, Christian</creatorcontrib><creatorcontrib>Heine, Alexander</creatorcontrib><creatorcontrib>Müller-Heinrich, Annegret</creatorcontrib><creatorcontrib>Knaak, Christine</creatorcontrib><creatorcontrib>Friesecke, Sigrun</creatorcontrib><creatorcontrib>Obst, Anne</creatorcontrib><creatorcontrib>Bollmann, Tom</creatorcontrib><creatorcontrib>Desole, Susanna</creatorcontrib><creatorcontrib>Boesche, Michael</creatorcontrib><creatorcontrib>Stubbe, Beate</creatorcontrib><creatorcontrib>Ewert, Ralf</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Warnke, Christian</au><au>Heine, Alexander</au><au>Müller-Heinrich, Annegret</au><au>Knaak, Christine</au><au>Friesecke, Sigrun</au><au>Obst, Anne</au><au>Bollmann, Tom</au><au>Desole, Susanna</au><au>Boesche, Michael</au><au>Stubbe, Beate</au><au>Ewert, Ralf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of survival after prolonged weaning from mechanical ventilation</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2020-12</date><risdate>2020</risdate><volume>60</volume><spage>212</spage><epage>217</epage><pages>212-217</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>Weaning from mechanical ventilation is a key component of intensive care treatment; however, this process may be prolonged as some patients require care at specialised centres. Current data indicate that weaning from invasive mechanical ventilation is successful in approximately 65% of patients; however, data on long-term survival after discharge from a weaning centre are limited.
We analysed predictors of survival among 597 patients (392 men, mean age 68 ± 11) post-discharge from a specialised German weaning centre.
Complete weaning from mechanical ventilation was achieved in 407 (57.8%) patients, and 106 patients (15.1%) were discharged with non-invasive ventilation; thus, prolonged weaning was successful in 72.9% of the patients. The one-year and five-year survival rates post-discharge were 66.5% and 37.1%, respectively. Age, duration of mechanical ventilation, certain clusters of comorbidities, and discharged with mechanical ventilation significantly influenced survival (p < .001). Completely weaned patients who were discharged with a tracheostomy had a significantly reduced survival rate than did those who were completely weaned and discharged with a closed tracheostomy (p = .004).
The identified predictors of survival after prolonged weaning could support therapeutic strategies during patients' intensive care unit stay. Patients should be closely monitored after discharge from a weaning centre.
•Data on long-term survival post-discharge from a weaning centre are limited.•We analysed predictors of survival among 597 patients from a German weaning centre.•Prolonged weaning was successful in 72.9% of the patients.•The 1- and 5-year survival rates post-discharge were 66.5% and 37.1%, respectively.•Age, ventilation duration, and some comorbidities significantly influenced survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32871419</pmid><doi>10.1016/j.jcrc.2020.08.010</doi><tpages>6</tpages></addata></record> |
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| subjects | Age Catecholamines Chronic obstructive pulmonary disease Extubation Heart failure Hospitals Intensive care Mechanical ventilation Patients Pneumonia Post traumatic stress disorder Sepsis Survival Tracheostomy Ventilation Ventilators Weaning |
| title | Predictors of survival after prolonged weaning from mechanical ventilation |
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