Weaning from mechanical ventilation in intensive care units: a call for new international consensus guidelines

In The Lancet Respiratory Medicine, Tài Pham and colleagues 1 Pham T Heunks L Bellani G et al. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study. Lancet Respir Med. 2023; (published online Jan 21.)https://doi.org/10.1016/S2213-2600(22)00449-0 Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar report the results of the WEAN SAFE study, aiming to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. WEAN SAFE was an international, multicentre, prospective, observational study including 5869 critically ill adult patients, conducted in 481 intensive care units in 50 countries. 1 Pham T Heunks L Bellani G et al. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study. Lancet Respir Med. 2023; (published online Jan 21.)https://doi.org/10.1016/S2213-2600(22)00449-0 Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar The authors can be congratulated for this large convenience sample reporting novel and important findings. The main result was that only 3817 (65·0%) patients were successfully weaned at day 90—ie, without reintubation within 7 days of extubation. WEAN SAFE is the first study reporting data relating long-term weaning practices to outcomes from invasive mechanical ventilation in a global cohort of patients at risk for weaning failure. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort studyIn critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Full-Text PDF