Outcomes after prolonged weaning in COPD patients – Data from the German WeanNet-Initiative

M. Wollsching-Strobel (Cologne, Germany), T. Freundt (Hanover, Germany), N. Hämäläinen (Hanover, Germany), S. Suchi (Hanover, Germany), W. Windisch (Cologne, Germany), B. Schönhofer (Bielefeld, Germany)

Source: Respiratory Failure and Mechanical Ventilation Conference 2022 - Opening session: Essentials of respiratory physiology - Assessment of respiratory muscle function - Pulmonary infections in mechanically ventilated patients - Telemonitoring of patients with chronic respiratory failure - Diagnostics and interventions - Acute respiratory failure: COVID-19 - Interstitial lung disease and pulmonary hypertension - Early rehabilitation - Acute respiratory failure: Invasive mechanical ventilation - HFNO and NIV for acute hypoxemic failure - Longterm NIV miscellaneous - Controversies in acute respiratory failure - The role of respiratory muscle dysfunction in weaning failure - Transitions in chronic NIV - New insights in weaning from invasive ventilation - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Difficult weaning from mechanical ventilation - Chronic ventilatory support in different diseases: Is one way fitting all? - Strategies to optimise early mobilisation and rehabilitation in intensive care - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Acute respiratory failure: Hypercapnic and diagnosis - Weaning from mechanical ventilation

Session: Weaning from mechanical ventilation
Session type: Oral poster discussion
Number: 111

Abstract

Aims/Objectives: The outcome of prolonged weaning in COPD-patients is still unclear.

Methods: A subgroup analysis of 2937 COPD-patients (median: age 69 years, 5 co-morbidities, 43% female) from the entire WeanNet cohort of specialized German weaning centers previously published (N=11424) was performed.

Results: Successful weaning without subsequent long-term non-invasive ventilation (NIV): N=900; 30.6%; successful weaning with subsequent long-term NIV: N=900; 30.6%; weaning failure with subsequent long-term invasive ventilation: N=780; 26.6%; and death: N=357; 12.2%. Most important predictors of mortality and weaning failure were advanced age and duration of mechanical ventilation in the transferring ICU. On discharge, the tracheostoma was closed in only 53% and 59% of patients with successful weaning not receiving and receiving long-term NIV. Unsuccessfully weaned patients were predominantly discharged home (20.5%) or to long-term care facilities (57.2%). Successfully weaned patients were predominantly discharged home (22.4%/35.9%: without/with NIV) and to rehabilitation (41.0%/43.1%: without/with NIV) (Fig.1).

Conclusion: COPD forms an important subgroup of prolonged weaning patients. Following transfer from the ICU to a specialized weaning center, weaning is successful more than 60%. Importantly, both tracheostomy status and initial destination following discharge are highly dependent on weaning outcome.

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Citations should be made in the following way:
M. Wollsching-Strobel (Cologne, Germany), T. Freundt (Hanover, Germany), N. Hämäläinen (Hanover, Germany), S. Suchi (Hanover, Germany), W. Windisch (Cologne, Germany), B. Schönhofer (Bielefeld, Germany). Outcomes after prolonged weaning in COPD patients – Data from the German WeanNet-Initiative. Respiratory Failure and Mechanical Ventilation Conference 2022 - Opening session: Essentials of respiratory physiology - Assessment of respiratory muscle function - Pulmonary infections in mechanically ventilated patients - Telemonitoring of patients with chronic respiratory failure - Diagnostics and interventions - Acute respiratory failure: COVID-19 - Interstitial lung disease and pulmonary hypertension - Early rehabilitation - Acute respiratory failure: Invasive mechanical ventilation - HFNO and NIV for acute hypoxemic failure - Longterm NIV miscellaneous - Controversies in acute respiratory failure - The role of respiratory muscle dysfunction in weaning failure - Transitions in chronic NIV - New insights in weaning from invasive ventilation - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Difficult weaning from mechanical ventilation - Chronic ventilatory support in different diseases: Is one way fitting all? - Strategies to optimise early mobilisation and rehabilitation in intensive care - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Acute respiratory failure: Hypercapnic and diagnosis - Weaning from mechanical ventilation

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