The following is the summary of “Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19” published in the January 2023 issue of Respiratory Care by Dorado, et al.

Patients who need mechanical ventilation for COVID-19 exhibit distinct patterns of progression and results compared to the wider population in the ICU. The benefits of early weaning from mechanical ventilation are well-established; nevertheless, extubation failure and prolonged use of the ventilator can occur if patients who are unable to be weaned are not properly identified. Weaning from mechanical ventilation has mixed results in this population. The purpose of this research was, therefore, to characterize the process of weaning people from mechanical ventilation who had had acute respiratory failure due to COVID-19 infection.

This was a multi-center, prospective cohort research. Patients over 18 who were admitted to one of the involved ICUs and required mechanical ventilation for more than 12 hours because of a COVID-19 infection were included. Primary outcome variables included procedural characteristics and clinical outcomes associated with weaning and extubation from mechanical ventilation. The different types of weaning were classified using established criteria. Researchers found that 326 people from 8 different intensive care units were studied. A spontaneous breathing trial (SBT) was not completed in 52.1% of individuals. Around 128  participants were extubated, and 29.7% required re-intubation. 

There were statistically significant differences in the lengths of time each subject required mechanical ventilation (P<.001) and stayed in the intensive care unit (ICU) (P<.001) when sorted into groups based on Weaning according to a New Definition (WIND) classification (group 0=52.1%, group 1=28.5%, group 2=8.0%, and group 3=11.3%). The disease significantly influenced the mechanical ventilation weaning process in participants with COVID-19, with many subjects never completing an SBT. The clinical results in each weaning group were comparable despite the fact that temporal variables were changed.

Source: rc.rcjournal.com/content/68/1/101