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Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study

The knowledge of weaning ventilation period is fundamental to understand the causes and consequences of prolonged weaning. In 2007, an International Consensus Conference (ICC) defined a classification of weaning used worldwide. However, a new definition and classification of weaning (WIND) were sugg...

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Autores principales: Lago, Alessandra Fabiane, Gastaldi, Ada Clarice, Mazzoni, Amanda Alves Silva, Tanaka, Vanessa Braz, Siansi, Vivian Caroline, Reis, Isabella Scutti, Basile-Filho, Anibal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824706/
https://www.ncbi.nlm.nih.gov/pubmed/31626115
http://dx.doi.org/10.1097/MD.0000000000017534
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author Lago, Alessandra Fabiane
Gastaldi, Ada Clarice
Mazzoni, Amanda Alves Silva
Tanaka, Vanessa Braz
Siansi, Vivian Caroline
Reis, Isabella Scutti
Basile-Filho, Anibal
author_facet Lago, Alessandra Fabiane
Gastaldi, Ada Clarice
Mazzoni, Amanda Alves Silva
Tanaka, Vanessa Braz
Siansi, Vivian Caroline
Reis, Isabella Scutti
Basile-Filho, Anibal
author_sort Lago, Alessandra Fabiane
collection PubMed
description The knowledge of weaning ventilation period is fundamental to understand the causes and consequences of prolonged weaning. In 2007, an International Consensus Conference (ICC) defined a classification of weaning used worldwide. However, a new definition and classification of weaning (WIND) were suggested in 2017. The objective of this study was to compare the incidence and clinical relevance of weaning according to ICC and WIND classification in an intensive care unit (ICU) and establish which of the classifications fit better for severely ill patients. This study was a retrospective cohort study in an ICU in a tertiary University Hospital. Patient data, such as population characteristics, mechanical ventilation (MV) duration, weaning classification, mortality, SAPS 3, and death probability, were obtained from a medical records database of all patients, who were admitted to ICU between January 2016 and July 2017. Three hundred twenty-seven mechanically ventilated patients were analyzed. Using the ICC classification, 82% of the patients could not be classified, while 10%, 5%, and 3% were allocated in simple, difficult, and prolonged weaning, respectively. When WIND was used, 11%, 6%, 26%, and 57% of the patients were classified into short, difficult, prolonged, and no weaning groups, respectively. Patients without classification were sicker than those that could be classified by ICC. Using WIND, an increase in death probability, MV days, and tracheostomy rate was observed according to weaning difficult. Our results were able to find the clinical relevance of WIND classification, mainly in prolonged, no weaning, and severely ill patients. All mechanically ill patients were classified, even those sicker with tracheostomy and those that could not finish weaning, thereby enabling comparisons among different ICUs. Finally, it seems that the new classification fits better in the ICU routine, especially for more severe and prolonged weaning patients.
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spelling pubmed-68247062019-11-19 Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study Lago, Alessandra Fabiane Gastaldi, Ada Clarice Mazzoni, Amanda Alves Silva Tanaka, Vanessa Braz Siansi, Vivian Caroline Reis, Isabella Scutti Basile-Filho, Anibal Medicine (Baltimore) 3900 The knowledge of weaning ventilation period is fundamental to understand the causes and consequences of prolonged weaning. In 2007, an International Consensus Conference (ICC) defined a classification of weaning used worldwide. However, a new definition and classification of weaning (WIND) were suggested in 2017. The objective of this study was to compare the incidence and clinical relevance of weaning according to ICC and WIND classification in an intensive care unit (ICU) and establish which of the classifications fit better for severely ill patients. This study was a retrospective cohort study in an ICU in a tertiary University Hospital. Patient data, such as population characteristics, mechanical ventilation (MV) duration, weaning classification, mortality, SAPS 3, and death probability, were obtained from a medical records database of all patients, who were admitted to ICU between January 2016 and July 2017. Three hundred twenty-seven mechanically ventilated patients were analyzed. Using the ICC classification, 82% of the patients could not be classified, while 10%, 5%, and 3% were allocated in simple, difficult, and prolonged weaning, respectively. When WIND was used, 11%, 6%, 26%, and 57% of the patients were classified into short, difficult, prolonged, and no weaning groups, respectively. Patients without classification were sicker than those that could be classified by ICC. Using WIND, an increase in death probability, MV days, and tracheostomy rate was observed according to weaning difficult. Our results were able to find the clinical relevance of WIND classification, mainly in prolonged, no weaning, and severely ill patients. All mechanically ill patients were classified, even those sicker with tracheostomy and those that could not finish weaning, thereby enabling comparisons among different ICUs. Finally, it seems that the new classification fits better in the ICU routine, especially for more severe and prolonged weaning patients. Wolters Kluwer Health 2019-10-18 /pmc/articles/PMC6824706/ /pubmed/31626115 http://dx.doi.org/10.1097/MD.0000000000017534 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 3900
Lago, Alessandra Fabiane
Gastaldi, Ada Clarice
Mazzoni, Amanda Alves Silva
Tanaka, Vanessa Braz
Siansi, Vivian Caroline
Reis, Isabella Scutti
Basile-Filho, Anibal
Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study
title Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study
title_full Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study
title_fullStr Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study
title_full_unstemmed Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study
title_short Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients: A retrospective cohort study
title_sort comparison of international consensus conference guidelines and wind classification for weaning from mechanical ventilation in brazilian critically ill patients: a retrospective cohort study
topic 3900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824706/
https://www.ncbi.nlm.nih.gov/pubmed/31626115
http://dx.doi.org/10.1097/MD.0000000000017534
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