Weaning from Invasive Ventilation in Specialist Centers Following Primary Weaning Failure
- 20 March 2020
- journal article
- research article
- Published by Deutscher Arzte-Verlag GmbH in Deutsches Ärzteblatt international
- Vol. 117 (12), 205-210
- https://doi.org/10.3238/arztebl.2020.0205
Abstract
Background: Ever more patients are being treated with invasive ventilation in the outpatient setting. Most have no access to a structured weaning process in a specialized weaning center. The personal burden on the patients is heavy, and the costs for the health care system are high. Methods: 61 patients who had been considered unfit for weaning were admitted to a weaning center. The primary endpoint was the number of patients who had been successfully weaned from the ventilator at six months. The comparison group consisted of health-insurance datasets derived from patients who were discharged from an acute hospital stay to receive invasive ventilation in the outpatient setting. Results: 50 patients (82%; 95% confidence interval [70.5; 89.6]) were successfully weaned off of invasive ventilation in the weaning centers, 21 of them (34% [23.8; 47]) with the aid of non-invasive ventilation. The survival rate at 1 year was higher than in the group without invasive ventilation (45/50. or 90%, versus 6/11.or 55%); non-invasive ventilation was comparable in this respect to no ventilation at all. The identified risk factors for weaning failure included the presence of more than five comorbidities and a longer duration of invasive ventilation before transfer to a weaning center. Conclusion: If patients with prolonged weaning are cared for in a certified weaning center before being discharged to receive invasive ventilation in the outpatient setting, the number of persons being invasively ventilated outside the hospital will be reduced and the affected persons will enjoy a higher survival rate. This would also spare nursing costs.Keywords
This publication has 24 references indexed in Scilit:
- Inpatient and long‐term outcomes of individuals admitted for weaning from mechanical ventilation at a specialized ventilation weaning unitRespirology, 2012
- Medical and Economic Implications of Prolonged Mechanical Ventilation and Expedited Post-Acute CareSeminars in Respiratory and Critical Care Medicine, 2012
- Frustranes Weaning: Nachsorge durch das Weaningzentrum – Hausbesuche bei invasiv beatmeten PatientenPneumologie, 2011
- Characteristics and Outcomes of Ventilated Patients According to Time to Liberation from Mechanical VentilationAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Patients’ characterization, hospital course and clinical outcomes in five Italian respiratory intensive care unitsIntensive Care Medicine, 2009
- Incidence and outcome of weaning from mechanical ventilation according to new categoriesEuropean Respiratory Journal, 2009
- Entwöhnung von der BeatmungstherapieDeutsche Medizinische Wochenschrift (1946), 2008
- Weaning from mechanical ventilationEuropean Respiratory Journal, 2007
- Management of Patients Requiring Prolonged Mechanical VentilationSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2005
- Outcomes, cost and long term survival of patients referred to a regional weaning centreThorax, 2005