Refined WIND classification: incidence and outcomes of weaning groups

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. Footnotes Cite this article as: ERJ Open Research 2022; 8: Suppl. 9, 29. This article was presented at the 2022 ERS Respiratory Failure and Mechanical Ventilation Conference, in session “Poster Session 2”. This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at [www.ers-education.org][1] (ERS member access only). [1]: http://www.ers-education.org