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Journal Article Multicenter Study Epublish 1 citation

PubMed: 42823746 DOI: 10.1186/s13054-026-06357-3

A specialist-led interprofessional weaning program to prevent weaning failure in high-risk patients: the PRiVENT study.

Crit Care 30(1)

Authors: Franziska C Trudzinski, Benjamin Neetz, Biljana Joveš, Axel Kempa, Armin Schneider, Elena Biehler, Thomas Fleischhauer, Janina Schubert-Haack, Teresa Byczkowski, Manuel Feißt, Peter Rosenberger, Jörg Krebs, Simone Britsch, Joachim Szecsenyi, Felix J F Herth

Affiliations

  • Department of Pneumology and Critical Care, Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
  • Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany.
  • Department of Pneumology and Critical Care, Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
  • Department of Pneumology and Critical Care, SLK-Klinik Löwenstein, Löwenstein, Germany.
  • Department of Pneumology and Respiratory Medicine, RBK Lungenzentrum Stuttgart at Robert-Bosch-Krankenhaus, Stuttgart, Germany.
  • Department of Anesthesia and Intensive Care Medicine Waldburg-Zeil Kliniken, Wangen im Allgäu, Germany.
  • Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
  • aQua Institute for Applied Quality Improvement and Research in Health Care, Göttingen, Germany.
  • Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
  • Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
  • Department of Anesthesiology and Critical Care Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68165, Mannheim, Germany.
  • Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, Centre for Acute Cardiovascular Medicine Mannheim (ZKAM), University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117, Mannheim, Germany.
  • German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, 13092, Mannheim, Germany.
  • European Center for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, 68167, Mannheim, Germany.
  • Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany.

Abstract

PURPOSE

Effective strategies to prevent weaning failure and prolonged invasive mechanical ventilation (IMV) in patients at high risk of weaning failure are limited. We evaluated a structured, specialist-led interprofessional weaning program.

METHODS

In this prospective, multicenter, non-randomized interventional study, mechanically ventilated patients were screened 96 h to 11 days after intubation. Patients meeting predefined high-risk criteria received a specialist-led interprofessional weaning program, while a parallel control group was derived from health insurance claims data. The primary outcome was successful weaning at ICU discharge.

RESULTS

The primary analysis included 349 intervention patients and 1,768 controls. Successful weaning occurred in 58.3% of intervention patients and 51.7% of controls. In the adjusted primary analysis, the odds ratio for successful weaning was 1.46 (95% CI, 0.99-2.17; P = 0.057), and the difference did not reach statistical significance. In prespecified propensity score-matched analysis, successful weaning occurred in 58.3% of intervention patients and 46.4% of matched controls (OR, 2.90; 95% CI, 1.61-5.24; P < 0.001). An exploratory analysis restricted to ICU survivors also showed higher odds of successful weaning in the intervention group (OR, 2.10; 95% CI, 1.09-4.04; P = 0.026). Overall, 16.3% of intervention patients were transferred to a specialized weaning center. These patients had longer ventilation durations, contributing to a longer overall duration of IMV in the intervention group.

CONCLUSIONS

The PRiVENT intervention was feasible and successful weaning was numerically more frequent in the intervention group, although the prespecified adjusted primary analysis did not reach statistical significance. These findings suggest a potential benefit of structured, multidisciplinary weaning support.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05260853, registered on March 2, 2022.

MeSH

Ventilation, Weaning