title: Can integrative weaning index be a routine predictor for weaning success?
abstract: OBJECTIVE
  To assess the effectiveness of integrative weaning index (IWI) as a predictor of weaning success.
  
  
  METHODS
  This is a prospective randomized controlled observer-blinded study and carried out on 120 patients of both sexes; patients who received mechanical ventilation for more than 24 h and met defined criteria for a weaning trial, underwent a 2-h spontaneous breathing trial with either IWI plus routine criteria of weaning (Group I n = 60) or routine criteria of weaning alone (control group) (Group C n = 60), in Group C the IWI was measured retrospective as it is not used in weaning decision. Those tolerated the trial would be immediately extubated. The primary outcome measure was the ability to maintain spontaneous, unassisted breathing for more than 48 h after extubation. Secondary outcome measures were the duration of mechanical ventilation, length of Intensive Care Unit (ICU) stay, and length of hospital stay.
  
  
  RESULTS
  The mean duration (hours) of mechanical ventilation and length of ICU stay (days) were significantly shorter in the Group I where the IWI was used (83.6 ± 34.3 vs. 97.49 ± 47.2 h, P = 0.002 and 5.5 ± 1.6 vs. 7.12 ± 2.3 days, P = 0.03, respectively). Weaning success rate was significantly higher in the Group I (53 vs. 34, P = 0.0001) while weaning failure rate was significantly lower in the Group I C (7 vs. 26, P = 0.0001).
  
  
  CONCLUSIONS
  IWI is a strong predictor of both successful and failed weaning.
authors.affiliation: Department of Anesthesia and Intensive Care Unit, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt.
authors.forename: Ghada F
authors.initials: GF
authors.lastname: El-Baradey
authors.affiliation: Department of Anesthesia and Intensive Care Unit, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt.
authors.forename: Nagat S
authors.initials: NS
authors.lastname: El-Shmaa
authors.affiliation: Department of Chest, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt.
authors.forename: Salwa A
authors.initials: SA
authors.lastname: Ganna
keywords: Adult; integrative weaning index; ventilator weaning; weaning parameters; weaning protocol
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