Factors associated with failure to wean children from mechanical ventilators

Dyah Kanya Wati; Antonius Pudjiadi; Abdul Latief

doi:10.14238/pi53.2.2013.59-64

Dyah Kanya Wati Department of Child Health, Udayana University Medical School/Sanglah Hospital
Antonius Pudjiadi Department of Child Health, Udayana University Medical School/Sanglah Hospital
Abdul Latief Department of Child Health, Udayana University Medical School/Sanglah Hospital

DOI: https://doi.org/10.14238/pi53.2.2013.59-64

Keywords: weaning, mechanical ventilation, children, intensive care

Abstract

Background Patients with failure to wean from mechanical
ventilators in 48 hours have increased risk of morbidity, however
only a few protocols can be used for children.
Objective To assess possible factors associated with failure to
wean from mechanical ventilators in the pediatric intensive care
unit (PICU).
Methods This cross sectional study performed from June 2011 to
June 2012 had 124 subjects with 79 patients who were successfully
weaned and 45 patients who fail to be wean ed from mechanical
ventilators. Data was analyzed by 2x2 contingency tables. Results
with P value <0.05 were further analysis by logistic regression
multivariate analysis.
Results Factors associated with failure to wean from mechanical
ventilators were abn ormal electrolyte (P= 0.001) and acid
base status (P <0.001), lower ratio between tidal volume
(TV)/inspiration time (IT) (P<0.001), lower mechanical load
(P <0.001), and longer duration of mechanical ventilator use
(P<0.001). Multivariate analyses revealed that the significant
risk factors for failure to wean were TV/IT (OR6.0; 95%CI3.5 to
7.5; P= 0.001) , mechanical load (OR 11.5, 95%CI 10.3 to 15.5;
P= 0.002), and duration of mechanical ventilator use (OR 12.5;
95%CI 8.5to 14.9; P=0.026).
Conclusions Lower ratio of TV /IT and mechanical load, as well
as longer duration of ventilator use are factors associated with
failure to wean from a mechanical ventilator.

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