Weaning Failure in Elderly Patients: A Systematic Review and Meta-Analysis.

Abstract

Background/Objectives: Weaning failure in elderly patients undergoing mechanical ventilation presents a complex clinical challenge due to age-related physiological changes and comorbidities. Understanding the dynamics of this phenomenon through systematic analysis can provide valuable insights for clinical management. This meta-analysis aims to investigate the factors contributing to weaning failure in elderly patients and to assess the efficacy of different strategies in mitigating this challenge. Design: The design of this study is a systematic review and meta-analysis. Methods: A systematic search of electronic databases was conducted to identify relevant studies focusing on weaning failure in elderly patients. Studies reporting outcomes related to mechanical ventilation weaning failure were included. Data extraction, quality assessment, and statistical analysis were performed following established guidelines. Results: A total of 15 studies met the inclusion criteria and were included in the meta-analysis. The average age of participants throughout the studies was 66.24 ± 10.21 years. This suggests that the study population largely consisted of older adults and displayed a moderate range of ages centered around the mean. The rate of weaning failure across these studies was slightly above 31.56%, indicating a significant occurrence of this complication in the patient cohorts. The analysis revealed age-related physiological changes, such as decreased respiratory muscle strength and increased chest wall stiffness, as significant contributors to weaning failure in elderly patients. Comorbidities, including chronic pulmonary diseases and cardiovascular conditions, further exacerbated the challenge. Various interventions, including tailored weaning protocols and respiratory therapies, showed promising results in improving weaning outcomes in this population. Conclusions: Weaning failure in elderly patients undergoing mechanical ventilation is influenced by a combination of age-related physiological changes and comorbidities. Tailored interventions addressing these factors are essential for optimizing weaning success rates in this vulnerable population. Further research is warranted to refine the strategies and enhance outcomes in elderly patients requiring mechanical ventilation.