A single-centre seven-year experience with mechanical ventilation weaning

Weaning from mechanical ventilation is a growing and challenging issue in modern intensive care medicine. We aimed to describe a 7-year experience in mechanical ventilation weaning of a single centre in Germany.

We retrospectively analysed data regarding 403 patients admitted between 2007 and 2013 with difficult or prolonged mechanical ventilation weaning.

There were 261 men (64.8%) in the population. The median age was 72 (IQR 63; 77) years. The underlying reasons for ventilator dependence comprised: post-operative respiratory failure (56.3%), exacerbation of chronic obstructive pulmonary disease (14.4%) and pneumonia (7.4%). A tracheostomy was performed about 9 (IQR 7; 14) days after the last attempt of a spontaneous breathing trial, usually with the percutaneous method (89.3%). The median length of stay was 28 (IQR 20; 41) days. Sixty-five (16.1%) patients died. Among the survivors, complete ventilator independence was achieved in 316 (78.4%) subjects while 94 (29.7%) of them required a tracheal tube on discharge. The vast majority of patients were discharged to rehabilitation clinics (56.1%). All of the analysed parameters did not statistically significantly differ between consecutive years in the investigated period.

Our initial results of mechanical ventilation weaning are encouraging, repeatable in subsequent years of observation and consistent with the literature data. Assessing the predictors of successful mechanical ventilation weaning requires further research.