Validation of a new WIND classification compared to ICC classification for weaning outcome
Abstract Background Although the WIND (Weaning according to a New Definition) classification based on duration of ventilation after the first separation attempt has been proposed, this new classification has not been tested in clinical practice. The objective of this cohort study was to evaluate the...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-11-01
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| Series: | Annals of Intensive Care |
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| Online Access: | http://link.springer.com/article/10.1186/s13613-018-0461-z |
| _version_ | 1818938768459038720 |
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| author | Byeong-Ho Jeong Kyeong Yoon Lee Jimyoung Nam Myeong Gyun Ko Soo Jin Na Gee Young Suh Kyeongman Jeon |
| author_facet | Byeong-Ho Jeong Kyeong Yoon Lee Jimyoung Nam Myeong Gyun Ko Soo Jin Na Gee Young Suh Kyeongman Jeon |
| author_sort | Byeong-Ho Jeong |
| collection | DOAJ |
| description | Abstract Background Although the WIND (Weaning according to a New Definition) classification based on duration of ventilation after the first separation attempt has been proposed, this new classification has not been tested in clinical practice. The objective of this cohort study was to evaluate the clinical relevance of WIND classification and its association with hospital mortality compared to the International Consensus Conference (ICC) classification. Methods All consecutive medical ICU patients who were mechanically ventilated for more than 24 h between July 2010 and September 2013 were prospectively registered. Patients were classified into simple, difficult, or prolonged weaning group according to ICC classification and Groups 1, 2, 3, or no weaning (NW) according to WIND classification. Results During the study period, a total of 1600 patients were eligible. These patients were classified by the WIND classification as follows: Group NW = 580 (36.3%), Group 1 = 617 (38.6%), Group 2 = 186 (11.6%), and Group 3 = 217 (13.6%). However, only 735 (45.9%) patients were classified by ICC classification as follows: simple weaning = 503 (68.4%), difficult weaning = 145 (19.7%), and prolonged weaning = 87 (11.8%). Clinical outcomes were significantly different across weaning groups by ICC classification and WIND classification. However, there were no statistical differences in successful weaning rate (96.6% vs. 95.2%) or hospital mortality (22.5% vs. 25.5%) between simple and difficult weaning groups by the ICC. Conversely, there were statistically significant differences in successful weaning rate (98.5% vs. 76.9%) and hospital mortality (21.2% vs. 33.9%) between Group 1 and Group 2 by WIND. Conclusions The WIND classification could be a better tool for predicting weaning outcomes than the ICC classification. |
| first_indexed | 2024-12-20T06:13:06Z |
| format | Article |
| id | doaj.art-915594fb3f1c4f3ab65024337a555c2e |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-20T06:13:06Z |
| publishDate | 2018-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-915594fb3f1c4f3ab65024337a555c2e2022-12-21T19:50:37ZengSpringerOpenAnnals of Intensive Care2110-58202018-11-01811910.1186/s13613-018-0461-zValidation of a new WIND classification compared to ICC classification for weaning outcomeByeong-Ho Jeong0Kyeong Yoon Lee1Jimyoung Nam2Myeong Gyun Ko3Soo Jin Na4Gee Young Suh5Kyeongman Jeon6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineIntensive Care Unit Nursing Department, Samsung Medical Center, Sungkyunkwan University School of MedicineIntensive Care Unit Nursing Department, Samsung Medical Center, Sungkyunkwan University School of MedicineIntensive Care Unit Nursing Department, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background Although the WIND (Weaning according to a New Definition) classification based on duration of ventilation after the first separation attempt has been proposed, this new classification has not been tested in clinical practice. The objective of this cohort study was to evaluate the clinical relevance of WIND classification and its association with hospital mortality compared to the International Consensus Conference (ICC) classification. Methods All consecutive medical ICU patients who were mechanically ventilated for more than 24 h between July 2010 and September 2013 were prospectively registered. Patients were classified into simple, difficult, or prolonged weaning group according to ICC classification and Groups 1, 2, 3, or no weaning (NW) according to WIND classification. Results During the study period, a total of 1600 patients were eligible. These patients were classified by the WIND classification as follows: Group NW = 580 (36.3%), Group 1 = 617 (38.6%), Group 2 = 186 (11.6%), and Group 3 = 217 (13.6%). However, only 735 (45.9%) patients were classified by ICC classification as follows: simple weaning = 503 (68.4%), difficult weaning = 145 (19.7%), and prolonged weaning = 87 (11.8%). Clinical outcomes were significantly different across weaning groups by ICC classification and WIND classification. However, there were no statistical differences in successful weaning rate (96.6% vs. 95.2%) or hospital mortality (22.5% vs. 25.5%) between simple and difficult weaning groups by the ICC. Conversely, there were statistically significant differences in successful weaning rate (98.5% vs. 76.9%) and hospital mortality (21.2% vs. 33.9%) between Group 1 and Group 2 by WIND. Conclusions The WIND classification could be a better tool for predicting weaning outcomes than the ICC classification.http://link.springer.com/article/10.1186/s13613-018-0461-zMechanical ventilationVentilator weaningTreatment outcomeClassification |
| spellingShingle | Byeong-Ho Jeong Kyeong Yoon Lee Jimyoung Nam Myeong Gyun Ko Soo Jin Na Gee Young Suh Kyeongman Jeon Validation of a new WIND classification compared to ICC classification for weaning outcome Annals of Intensive Care Mechanical ventilation Ventilator weaning Treatment outcome Classification |
| title | Validation of a new WIND classification compared to ICC classification for weaning outcome |
| title_full | Validation of a new WIND classification compared to ICC classification for weaning outcome |
| title_fullStr | Validation of a new WIND classification compared to ICC classification for weaning outcome |
| title_full_unstemmed | Validation of a new WIND classification compared to ICC classification for weaning outcome |
| title_short | Validation of a new WIND classification compared to ICC classification for weaning outcome |
| title_sort | validation of a new wind classification compared to icc classification for weaning outcome |
| topic | Mechanical ventilation Ventilator weaning Treatment outcome Classification |
| url | http://link.springer.com/article/10.1186/s13613-018-0461-z |
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