Weaning from prolonged mechanical ventilation. The experience at a regional weaning center.
OBJECTIVE
The aim of this study was to describe the facility, patient population, outcome of treatment, and survival of patients transferred to a regional weaning center (RWC) after prolonged mechanical ventilation in the ICU setting.


METHODS
Retrospective record review.


METHODS
Regional weaning center.


METHODS
Four hundred twenty-one consecutive ventilator dependent patients were transferred from ICU care for attempted weaning over a 36-month period.


RESULTS
Acute catastrophic surgical, traumatic, or septic illness resulted in ventilator dependency with much greater frequency than decompensated COPD. Of the 421 patients, 116 died and 287 survived with outcome known at discharge. Of the 287 who survived, 212 were freed from ventilator support. Patients who weaned were ventilator-dependent for 46.9 +/- 2.9 days before transfer to the RWC. Almost half of those weaned were discharged to their homes. Survival at 6 months and 1 year after discharge was 44 percent and 28 percent respectively, and it was greater for those at home than for those discharged to an extended care facility (ECF). The RWC care was approximately $1,500 per patient day less costly than ICU care, and $208 per patient day less costly than noninvasive respiratory care unit care.


CONCLUSIONS
Selected patients who become ventilator dependent for prolonged periods in the ICU may be transferred to an RWC with the expectation of successful weaning in a majority of cases.
Scheinhorn
D J
DJ
Barlow Respiratory Hospital, Los Angeles 90026.
Artinian
B M
BM
Catlin
J L
JL
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000191:economics; D017721:Hospital Costs; D006782:Hospitals, Special / Q000191:economics / Q000458:organization & administration; D006801:Humans; D008171:Lung Diseases / Q000628:therapy; D008297:Male; D010351:Patient Discharge; D010360:Patient Transfer; D012121:Respiration, Artificial; D012138:Respiratory Therapy; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000191:economics / Q000379:methods