Incidence and associated factors to simple, difficult and prolonged weaning in an intensive care unit
DOI:
https://doi.org/10.15448/1983-652X.2016.3.22503Keywords:
epidemiology, ventilator weaning, classification, intensive care units.Abstract
Introduction: The weaning classification is a useful and important tool in the intensive care units (ICUs) in order to know the reality of the service.
Objective: To determine the incidence of simple, difficult and prolonged weaning and its associated factors in patients admitted in a general ICU for adults.
Materials and Methods: A prospective cohort study was carried out in a great hospital in the countryside of Rio Grande do Sul state, Brazil, from January to April, 2014. We included 25 patients submitted to invasive mechanical ventilation (MV) for more than 24 hours and that performed the spontaneous breathing test.
Results: The incidence of simple, difficult and prolonged weaning were 52% (n=13), 32% (n=8) and 16% (n=4), respectively. The days in the ICU (p=0.039), days of MV (p=0.002), and days of weaning (p<0.001) were higher in the prolonged weaning group. The incidence of pneumonia associated to MV (p=0.016), tracheostomy (p=0.045), prolonged MV (p=0.011), and prolonged controlled MV (p=0.028) was higher in the prolonged weaning group. There was a trend toward higher mortality in the ICU in the prolonged weaning group, although without statistically significant difference (p=0.066).
Conclusion: Prolonged weaning is associated with increased days in the ICU, days of MV, and days of ventilator weaning, as well as the incidence of ventilator-associated pneumonia, tracheostomy, prolonged MV, and prolonged controlled MV. The results show that no efforts should be spared regarding weaning and it should be optimized to avoid or at least reduce complications and interventions.
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