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RISK FACTORS ASSOCIATED WITH WEANING FAILURE IN PEDIATRIC PATIENTS
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Abstract
Objective: Identifying predictors for weaning outcomes in pediatric patients is critically important—not only to reduce the risk of reintubation or avoid unnecessary delays in weaning that may prolong pediatric intensive care unit (PICU) stay—but also to guide the development of effective weaning strategies. Methods: This was a prospective descriptive study conducted at the Department of Medical Pediatric Intensive Care, National Children’s Hospital. The study enrolled patients aged from 30 days to 15 years who required invasive mechanical ventilation for ≥24 hours, met the criteria to undergo a Spontaneous Breathing Trial (SBT), and successfully completed the initial 2-hour SBT. Collected variables included: age, gender, history of prematurity, underlying medical conditions, primary diagnosis, duration of mechanical ventilation, time since sedative discontinuation prior to SBT, and weaning outcome (successful or failed). Results: A total of 106 patients met the inclusion criteria. Among them, 64.3% were under one year of age, and the male-to-female ratio was 2.3:1. Underlying medical conditions were present in 30.2% of patients, and 17.9% had a history of prematurity. The most common diagnosis was respiratory disease (56.7%). The overall weaning success rate was 92.5%, and the mean duration of mechanical ventilation was 6.7 ± 5.6 days. There was no statistically significant difference in weaning outcomes based on the presence of underlying disease, history of prematurity, or type of diagnosis (p > 0.05).The mean duration of mechanical ventilation was longer in the weaning failure group (9.3 ± 5.0 days) compared to the success group (5.5 ± 5.6 days), but this difference was not statistically significant (p = 0.09). Similarly, no significant difference in weaning outcomes was observed between patients whose sedative medications were discontinued more than 4 hours vs. less than 4 hours prior to SBT (p = 0.85). Conclusion: In our study population, factors such as history of prematurity, underlying conditions, etiology of respiratory failure, duration of mechanical ventilation, and timing of sedative discontinuation prior to SBT (≤ or > 4 hours) were not associated with weaning outcomes.
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Keywords
weaning, spontaneous breathing trial, pediatric intensive care
References
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