Role Of Integrative Weaning Index For Prediction Of Successful Weaning From Mechanical Ventilation

Objective: Weaning from mechanical ventilation (MV) requires a multidisciplinary care team. The Integrative Weaning Index (IWI) is a more objective measure compared to conventional methods, considering multiple system functions simultaneously. This study investigates the role of IWI in predicting successful weaning from MV. Material and Methods: This prospective observational study was conducted over twelve months at the Department of Anesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from March 2021 to February 2022. A total of 56 patients on mechanical ventilation eligible for weaning were included after obtaining informed written consent. IWI was calculated using SaO2, Cst, and f/Vt. Success was defined as an index level ≥25, and failure as <25. Data were analyzed using SPSS version 24. Results: The mean age of the subjects was 45.5 ± 8.93 years, with a male predominance of 60.7%. A successful spontaneous breathing trial (SBT) outcome was observed in 71.4% of patients. The receiver operating characteristics (ROC) curve determined a cut-off value of 25 for the IWI score, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 90%, 75%, 90%, 75%, and 85.7%, respectively. IWI demonstrated the highest area under the curve (AUC) of 0.875 compared to SaO2 (0.801), GCS (0.744), and RSBI (0.807). Conclusion: The Integrative Weaning Index is useful for predicting successful weaning from mechanical ventilation. However, larger multicenter studies are recommended.