Photo Credit: Darmoroz
The following is a summary of “Predictors of weaning failure in ventilated intensive care patients: a systematic evidence map,” published in the November 2024 issue of Critical Care by Sterr et al.
Ventilator weaning is vital for patients requiring intensive care to prevent complications. However, many patients fail weaning attempts due to insufficient spontaneous breathing. While various predictors of weaning failure have been studied, and the comprehensive overview of the predictors are lacking.
Researchers conducted a retrospective study to provide an overview of empirically investigated predictors for weaning failure.
They systematically searched Medline, Cochrane, and CINAHL databases in December 2023, followed by a citation search and manual search in June 2024. Only studies focusing on predictors for weaning failure in adults on ventilators in intensive care units were included, while studies involving children, outpatients, non-invasive ventilation, or factors explaining weaning failure were excluded, 2 reviewers independently screened and extracted data by using an inductive approach, the data was synthesized by thematically analyzing, categorizing, and clustering the predictors.
The results showed that, out of 1,388 records retrieved, 140 studies met the inclusion criteria for analysis, of these, 112 were prospective studies, and 28 were retrospective, examining 145 predictors. These predictors were categorized into 4 main clusters: ‘Imaging procedures’ (n=22), ‘Physiological parameters’ (n=61), ‘Scores and indices’ (n=53), and ‘Machine learning models’ (n=9). The most studied predictors included the rapid shallow breathing index, diaphragm thickening fraction, respiratory rate, P/F ratio, and diaphragm excursion.
They concluded that 145 predictors have been investigated in 140 studies, with recent research focusing on comprehensive assessments, indices, and machine learning models, aligning with international weaning definitions.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05135-3
