Abstract

Background: The WIND classification groups mechanically ventilated (MV) patients into ‘short’, ‘difficult’, ‘prolonged’ and ‘no weaning’, stratifying distinct short-term outcomes in mostly medical populations.

Aims: 1) To describe weaning group distribution, 2) To evaluate if ‘short wean’ patients can be divided into groups with distinct characteristics and outcomes, 3) To study 1-year outcomes related to weaning groups, in a mixed, mainly surgical ICU population.

Method: Retrospective study in a tertiary centre including all MV patients from April 11 2018, for 1 year onwards. A refined WIND classification was used, dividing ‘short wean’ patients into patients MV=24h versus MV>24.

Results: Of 1801 MV patients, 65% were categorized as ‘short MV=24h’, 13% ‘short MV>24h’, 8% ‘difficult’, 6% ‘prolonged’ and 8% ‘no weaning’ group. ‘Short MV=24h’ patients were significant older, more frequently male, had lower disease severity and different admission categories compared to ‘short MV>24h’. Weaning duration and success rate, ICU and hospital length of stay and mortality worsened increasingly from ‘short MV=24h’ to ‘prolonged’ weaning patients. 1-year mortality also increased from ‘short MV=24h’ (9%), to ‘short MV>24h’ (27%), ‘difficult’ (39%) and ‘prolonged’ weaning (49%). In adjusted analyses, weaning groups were also independently associated with 1-year mortality.

Conclusions: The high proportion of ‘short wean’ patients in this mainly surgical ICU population could be divided into 2 groups with distinct characteristics. This refined WIND classification allowed to enhance prognostication, also beyond hospitalization, highlighting the need to further optimize the weaning process.