Stratification of difficulty in weaning

Excerpt

The panelists of a recent International Consensus Conference on weaning from mechanical ventilation [1] proposed that weaning be categorized into three groups according to the difficulty and duration of the weaning process. According to the proposed classification, patients with simple weaning are those extubated at the first attempt of spontaneous breathing. Patients with difficult weaning are extubated within 7 days from the first trial of spontaneous breathing. Patients with prolonged weaning are those who fail at least three weaning attempts or who require more than 7 days of weaning [1]. In 2010, Funk et al. [2] assessed the usefulness of this classification by determining the outcome of more than 250 patients cared for in five Viennese general medical–surgical intensive care units (ICU). In that study, ICU and hospital mortality were greater in patients with prolonged weaning than in patients with simple or with difficult weaning. Ventilator-free days and ICU-free days were less in difficult and prolonged weaning than in simple weaning. …