WEANING FROM PROLONGED MECHANICAL VENTILATION - THE EXPERIENCE AT A REGIONAL WEANING CENTER

Study 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. Design: Retrospective record review. Setting: Regional weaning center. Patients: Four hundred twenty-one consecutive ventilator dependent patients were transferred from ICU care for attempted weaning over a 36-month period. Measurement and 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.