ArticleCritical care (London, England)2025
Impact of comorbidities on management and outcomes of patients weaning from invasive mechanical ventilation: insights from the WEAN SAFE study.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Handgrip strength association with weaning outcome in mechanically ventilated ICU patients: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Risk prediction models for extubation failure in critically ill patients on mechanical ventilation: a systematic review.Frontiers in medicine · 2025Pooled it
- Distinct weaning phenotypes in patients unsuccessful in weaning from invasive mechanical ventilation: a secondary analysis of the WEAN SAFE cohort.Intensive care medicine · 2026Observational
- Parasternal intercostal muscle thickening fraction predicts weaning failure in invasively ventilated patients with COPD: a prospective observational study.BMJ open respiratory research · 2026Observational
- Midaxillary-to-midclavicular diaphragmatic mobility ratio predicts weaning success in invasive mechanical ventilation: an observational cohort study.Quantitative imaging in medicine and surgery · 2026Article
- Prolonged mechanical ventilation and its associated factors among adult patients admitted to intensive care unit in the teaching hospitals of Southern Ethiopia In 2023: a multicenter prospective cohort study.BMC anesthesiology · 2026Article
- Machine learning-driven prediction model for successful weaning of patients from mechanical ventilation in ICU.Intensive care medicine experimental · 2026Article
- Management and outcomes in women and men weaning from invasive mechanical ventilation: insights from the WEAN SAFE study.Annals of intensive care · 2026Article
- Clinical Characteristics and Outcomes of Carbapenem-Resistant Gram-Negative Bacteria Pneumonia in Immunocompromised ICU Patients: A Retrospective Study.Infection and drug resistance · 2026Article
- Does obesity impact on weaning from invasive ventilation: a secondary analysis of the WEAN SAFE study.Annals of intensive care · 2025Article
- The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation.Frontiers in medicine · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of comorbidities on patients weaning from invasive ventilation is incompletely understood. We wished to understand the impact of the number and type of comorbidities on patients' weaning from invasive mechanical ventilation enrolled in the 'WorldwidE AssessmeNt of Separation of pAtients From ventilatory assistancE (WEAN SAFE) study.
methodsThe study population consisted of patients enrolled in the WEAN SAFE study that commenced the weaning process. We categorized patients by the number of comorbidities (none, 1, 2, or 3 plus), and by specific comorbidity type. The primary outcome was the impact of comorbidities on delayed weaning and failed weaning from invasive MV. Secondary outcomes included the impact of comorbidities on ICU and hospital survival, and decisions to limit life-sustaining interventions.
resultsOf 4523 patients in the study population, 1614 (35.7%) had one comorbidity, 889 (19.7%) had two comorbidities, 432 (9.6%) had three or more comorbidities, while 1562 (34.5%) had no comorbidities. The most frequently occurring comorbid conditions were respiratory (22%) and cardiovascular (11%). Patients with comorbidities were more likely to fail a separation attempt, more likely to receive an extubation attempt, and to require more than 1 extubation attempt. The proportion of patients with failed weaning from invasive MV increased progressively with increasing comorbidities. Neuromuscular comorbidities were associated with increased weaning duration. Weaning failure was increased with respiratory, hepatic, renal, neuromuscular, and immune dysfunction comorbidities. Hospital mortality rates increased progressively from 16% with no comorbidity to 34% with ≥ 3 comorbidities. Each specific comorbidity was independently associated with increased hospital mortality. The presence of comorbidities was associated with decisions to limit life sustaining interventions.
conclusionsMost patients weaning from invasive ventilation have comorbidities, which are associated with higher weaning failure risk and worse outcomes. The adverse impact of comorbidities on the weaning outcomes and of the process are not explained by a less aggressive approach to weaning.
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