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

Abstract

<b>Aims/Objectives:</b> The outcome of prolonged weaning in COPD-patients is still unclear. <b>Methods:</b> 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. <b>Results:</b> 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). <b>Conclusion:</b> 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.