title: Weaning critically ill patients from mechanical ventilation: A prospective cohort study.
abstract: OBJECTIVE
  A proposal was made at the International Consensus Conference to classify weaning of patients in intensive care units from mechanical ventilation into simple, difficult, and prolonged weaning groups based on the difficulty and length of the weaning process. The objective of the present study was to determine the incidence and outcome of weaning according to these new categories.
  
  
  METHODS
  We examined the weaning of patients in intensive care units from mechanical ventilation in a prospective multicenter cohort study.
  
  
  RESULTS
  In total, 343 patients were included in the final analysis. Simple, difficult, and prolonged weaning occurred in 200 (58%), 99 (29%), and 44 (13%) patients, respectively. Hospital mortality rates were higher for patients in the prolonged weaning group than in the simple and difficult weaning groups. Multivariate analysis revealed that a lower Glasgow Coma Scale score (P < .014) and hypercapnia at the beginning of the first spontaneous breathing trial (P = .038) were independent predictors of prolonged weaning.
  
  
  CONCLUSIONS
  Patients who experienced prolonged weaning had significantly higher mortality rates than patients who experienced either simple or difficult weaning. A lower Glasgow Coma Scale score and hypercapnia at the beginning of the weaning process were independent risk factors for prolonged weaning.
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China; Department of Critical Care Medicine, Capital Medical University, ICU Beijing Ditan Hospital, Beijing 100015, China. Electronic address: pulin1103@163.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Pu
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: zhubo123123@hotmail.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: jianglifx@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Medical Intensive Care Unit, MICU Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: dubin08@163.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Du
authors.affiliation: Department of Critical Care Medicine, ICU Peking University Third Hospital, Beijing 100191, China. Electronic address: xizhuccm@126.com.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Beijing Friendship Hospital, Beijing 100050, China.. Electronic address: liang_bjfh68@163.com.
authors.forename: Ang
authors.initials: A
authors.lastname: Li
authors.affiliation: Department of Critical Care Medicine, ICU China-Japan Friendship Hospital, Beijing 100029, China. Electronic address: ligangxdysw@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Critical Care Medicine, ICU The First Affiliated Hospital of General Hospital of People's Liberation Army, Beijing 100048, China. Electronic address: drhezhj@163.com.
authors.forename: Zhongjie
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Beijing Shijitan Hospital, Beijing 100038, China. Electronic address: chenweihanwa@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Critical Care Medicine, ICU The 309th Hospital of Chinese People's Liberation Army, Beijing 100094, China. Electronic address: mapenglin10@163.com.
authors.forename: Penglin
authors.initials: P
authors.lastname: Ma
authors.affiliation: Surgical Intensive Care Unit, Capital Medical University, SICU Xuan Wu Hospital, Beijing 100053, China. Electronic address: jiajianguo_1@163.com.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Jia
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Beijing Tong Ren Hospital, Beijing 100730, China. Electronic address: xyuan76@yeah.net.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Beijing Tian Tan Hospital, Beijing 100050, China. Electronic address: Zhoujx.cn@icloud.com.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Critical Care Medicine, ICU Beijing Haidian Hospital, Beijing 100080, China. Electronic address: qinlong1028@126.com.
authors.forename: Long
authors.initials: L
authors.lastname: Qin
authors.affiliation: Department of Respiratory, China-Japan Friendship Hospital, Beijing 100029, China. Electronic address: Zhanqy0915@126.com.
authors.forename: Qingyuan
authors.initials: Q
authors.lastname: Zhan
authors.affiliation: Surgical Intensive Care Unit, Capital Medical University, SICU Beijing Chao-Yang Hospital, Beijing 100020, China. Electronic address: lwx7115@163.com.
authors.forename: Wenxiong
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: jiangqi7676@126.com.
authors.forename: Qi
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: xiaolajiao001326@163.com.
authors.forename: Meiping
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: springin12@163.com.
authors.forename: Ran
authors.initials: R
authors.lastname: Lou
authors.affiliation: Department of Critical Care Medicine, Capital Medical University, ICU Fu Xing Hospital, Beijing 10038, China. Electronic address: xxm2937@yeah.net.
authors.forename: XiuMing
authors.initials: X
authors.lastname: Xi
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D006935:Hypercapnia / Q000453:epidemiology*; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods / Q000706:statistics & numerical data*
keywords: Epidemiology; Intensive care unit; Ventilation; Weaning