Factors associated with failure to wean children from mechanical ventilators

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.