Validation of the Modified Integrative Weaning Index as a Predictor of Weaning from Mechanical Ventilation in Comparison to Conventional Weaning Indices in Adult Critically Ill Patients.

Abstract

Mechanical ventilation is an essential therapy in the ICU, and a large percentage of the ICU patient population will need this therapy during their ICU stay. Weaning from mechanical ventilation remains to be a cumbersome process that occupies a large percentage of the total ventilation time of the patients. Failure to predict readiness for weaning from mechanical ventilation may result in prolonging mechanical ventilation or premature weaning resulting in complications. The weaning process remains to be a subjective decision made by the physician in charge of the patient. Multiple parameters and indices have been developed and studied over the years in order to improve and unify the weaning process and to try and develop a unified index/score, that is easily obtained and does not require invasive maneuvers or put that patient at risk to obtain, that could assess the patients’ respiratory system performance and readiness to be weaned from mechanical ventilation. Old respiratory indices and parameters, such as the respiratory rate, tracheal occlusion pressure, partial pressure of arterial carbon dioxide, CORE index, CROP index and oxygen saturation, still do not meet the required performance in evaluating the respiratory system performance and accurately