Influence of invasive ventilation modes on weaning and extubation evolution of critical patients

Abstract

The aim of this research was to analyze the influence of invasive ventilation modes on weaning and extubation process. It is a prospective cohort study that assessed patients admitted to the Intensive Care Unit (ICU) using Invasive Mechanical Ventilation (IMV). The following aspects were considered: ventilation mode used, days until evolution to weaning and extubation, its success/failure, hospitalization period, and ICU outcome (discharge/death). Sixty patients were assessed, 48 of which were admitted on volume-controlled ventilation (VCV), three on pressure-controlled ventilation (PCV), and nine on spontaneous mode. A total of 79% of VCV individuals and 67% of PCV went into spontaneous mode. There was no significant difference between modes for time until evolution to spontaneous breathing, neither between that and weaning and extubation. Among possible factors responsible for weaning and extubation success, only days on spontaneous mode influenced these outcomes, so individuals who breathed spontaneously for more days were 1.5% more likely to succeed at weaning and 1.3% more likely to succeed at extubation. The ventilation mode used at admission did not influence weaning and extubation process. Longer time on spontaneous breathing mode predicted the patients’ greater chances of weaning and extubation success.

Keywords

• artificial respiration
• ventilator weaning
• extubation
• intensive care units
• physiotherapy