Critical care (London, England) · 2026
A specialist-led interprofessional weaning program to prevent weaning failure in high-risk patients: the PRiVENT study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Trudzinski Franziska C, Neetz Benjamin, Joveš Biljana, Kempa Axel, Schneider Armin, Biehler Elena, Fleischhauer Thomas, Schubert-Haack Janina, Byczkowski Teresa, Feißt Manuel, Rosenberger Peter, Krebs Jörg, Britsch Simone, Szecsenyi Joachim, Herth Felix J F, PRiVENT-Study Group
Аннотация
PURPOSE: Effective strategies to prevent weaning failure and prolonged invasive mechanical ventilation (IMV) in patients at high risk of weaning failure are limited. We evaluated a structured, specialist-led interprofessional weaning program.
METHODS: In this prospective, multicenter, non-randomized interventional study, mechanically ventilated patients were screened 96 h to 11 days after intubation. Patients meeting predefined high-risk criteria received a specialist-led interprofessional weaning program, while a parallel control group was derived from health insurance claims data. The primary outcome was successful weaning at ICU discharge.
RESULTS: The primary analysis included 349 intervention patients and 1,768 controls. Successful weaning occurred in 58.3% of intervention patients and 51.7% of controls. In the adjusted primary analysis, the odds ratio for successful weaning was 1.46 (95% CI, 0.99-2.17; P = 0.057), and the difference did not reach statistical significance. In prespecified propensity score-matched analysis, successful weaning occurred in 58.3% of intervention patients and 46.4% of matched controls (OR, 2.90; 95% CI, 1.61-5.24; P < 0.001). An exploratory analysis restricted to ICU survivors also showed higher odds of successful weaning in the intervention group (OR, 2.10; 95% CI, 1.09-4.04; P = 0.026). Overall, 16.3% of intervention patients were transferred to a specialized weaning center. These patients had longer ventilation durations, contributing to a longer overall duration of IMV in the intervention group.
CONCLUSIONS: The PRiVENT intervention was feasible and successful weaning was numerically more frequent in the intervention group, although the prespecified adjusted primary analysis did not reach statistical significance. These findings suggest a potential benefit of structured, multidisciplinary weaning support.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT05260853, registered on March 2, 2022.
METHODS: In this prospective, multicenter, non-randomized interventional study, mechanically ventilated patients were screened 96 h to 11 days after intubation. Patients meeting predefined high-risk criteria received a specialist-led interprofessional weaning program, while a parallel control group was derived from health insurance claims data. The primary outcome was successful weaning at ICU discharge.
RESULTS: The primary analysis included 349 intervention patients and 1,768 controls. Successful weaning occurred in 58.3% of intervention patients and 51.7% of controls. In the adjusted primary analysis, the odds ratio for successful weaning was 1.46 (95% CI, 0.99-2.17; P = 0.057), and the difference did not reach statistical significance. In prespecified propensity score-matched analysis, successful weaning occurred in 58.3% of intervention patients and 46.4% of matched controls (OR, 2.90; 95% CI, 1.61-5.24; P < 0.001). An exploratory analysis restricted to ICU survivors also showed higher odds of successful weaning in the intervention group (OR, 2.10; 95% CI, 1.09-4.04; P = 0.026). Overall, 16.3% of intervention patients were transferred to a specialized weaning center. These patients had longer ventilation durations, contributing to a longer overall duration of IMV in the intervention group.
CONCLUSIONS: The PRiVENT intervention was feasible and successful weaning was numerically more frequent in the intervention group, although the prespecified adjusted primary analysis did not reach statistical significance. These findings suggest a potential benefit of structured, multidisciplinary weaning support.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT05260853, registered on March 2, 2022.