Factors affecting the outcome of weaning from mechanical ventilation in patients with tracheostomy in the Intensive Care Unit

Abstract

Introduction: Although most patients are easily released from mechanical ventilation, however almost 10% need prolonged mechanical ventilation and undergo a tracheostomy. Aim: Aim of this study was to investigate the factors that may influence the weaning process in tracheostomy patients in the ICU. Methodology: A retrospective cohort study was conducted. Data were collected from the records of 85 adult patients who underwent tracheostomy during their hospitalization in the ICU of a General Regional Hospital, from 2016-2020. For the data collection, a demographic, clinical data recording form and the mechanical ventilation evaluation scale (VIS) were used, recording the 1st, 5th and 10th day after the tracheostomy. The analysis of the study data was done using the SPSS program (IBMCorp. 2019, IBM SPSS Statistics for Windows, v.26.0, Armonk). Results: The total percentage of patients who were successfully weaned was 40%. Patients with successful weaning had significantly lower: Charlson Comorbidity Index score (3.7 vs. 5.0) and higher score on the sum of positive cultures (0-3) (p=0.043). Patients with successful weaning were found to have significantly higher levels of VIS index the 5th (66.6 vs. 33.0) and 10th day (79.8 vs. 34.7). Also, they were positively correlated with the score in the sum of positive cultures (0-3) and with a lower score of VIS 5th (rho = -0.337, p = 0.002) and 10th day (rho = -0.2295, p = 0.012). Finally, through Cox regression, prognostic factors for weaning outcome, multiple diseases (comorbidity) and the duration of mechanical ventilation were assessed. Conclusions: Factors affecting the outcome of weaning were identified. In addition, the value of the VIS prognostic model in the ICU of a General Regional Hospital was confirmed.