Factors associated with weaning success from prolonged mechanical ventilation in surviving Chinese pediatric intensive care units: a multicenter analysis.

OBJECTIVE

To describe factors of ventilation strategies associated with weaning success for surviving patients from prolonged mechanical ventilation (PMV) in Pediatric Intensive Care Units (PICUs).

METHODS

Conducted a retrospective study across eleven PICUs in mainland China from January 1, 2021, to December 31, 2022.

RESULTS

234 patients diagnosed with PMV were included in the study. Weaning Outcomes: 58.1% (136 patients) successfully weaned, includeing 11.1% (26 patients) required only a tracheostomy. 9.8% (23 patients) needed non-invasive ventilation. 32. 1% (75 patients) continued to require mechanical ventilation. 34.2% (80 patients) on invasive pressure control mode at PMV diagnosis. Pressure control was the most commonly used method. Synchronized intermittent mandatory ventilation (SIMV) used by 30.4% (71 patients). Pressure support ventilation (PSV) used by 5. 1% (12 patients). 63.2% (148 patients) received physiotherapy. 44.9% (105 patients) received cough augmentation techniques. 26.9% (63 patients) underwent tracheostomy after an average of 29 days of invasive mechanical ventilation. Higher fraction of inspired oxygen (FiO2) on PMV diagnosis day associated with weaning failure, the OR value is 0.674. While lower airway diseases had one more times chance of weaning seccess than central nervous system diseases, the OR value is 2.144.

CONCLUSION

Among survivors, ventilation strategies for PMV weaning in Chinese PICUs are diverse, with pressure control commonly used initially, followed by SIMV and PSV. We identified a higher FiO2 at PMV diagnosis as risk factors for weaning failure, while lower airway diseases were easier to wean.