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

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.

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Journal
Critical Care
Published
2026-09-30
DOI
https://doi.org/10.1186/s13054-026-06357-3
Primary Topic
Respiratory Support and Mechanisms
Type
article
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article

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

Ingo Rebenschütz, Jörg Winckelmann, Brigitte Mayer, Swenja Walcher et al.
Critical Care
Respiratory Support and Mechanisms
article

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

Ingo Rebenschütz, Jörg Winckelmann, Brigitte Mayer, Swenja Walcher, Patrick Keppeler, Sebastian Allgäuer, Anja Klingenberg, Jörg Krebs, Mark Hackbarth, Patrick Gehrig, Stefanie Bientzle, Julia Dorothea Michels-Zetsche, Christa Straub, Joanna Paderewska, Alexej Schöpp, Boris Nohé, Florian Seidlitz, Selina Briese, G. Iberl, Simone Britsch, Alessandro Ghiani, Sebastian Münz, Joachim Sugg, Andreas Rheinhold, Janina Schubert-Haack, Uta Merle, Markus Qreini, Thomas Fleischhauer, Armin Schneider, J Szecsenyi, Imke Hübner, Benjamin Schempf, Franziska Christina Trudzinski, Petra Denzer, Monica Boxberger, Claus Neurohr, Peter-Tobias Graf, Susanne Hirschmann, Konstantin Frey, Benjamin Neetz, Κωνσταντίνος Τσίτουρας, Biljana Joveš, Guido Hundt, Reimer Rießen, Markus Kredel, Miriane Bomeken, Dominik Scharpf, Philipp Höger, Thomas J. Dengler, Teresa Byczkowski, Thushira Weerawarna, Lisa Amega, Oliver Gorgs, Andrzej Kuzniar, Mascha Fiedler-Kalenka, Peter Rosenberger, Elena Biehler, Felix JF Herth, Manuel Feisst, Helene Häberle, Axel Kempa, Michael Hahn, Thomas Grobe, Holger Wolff, Mathias Borst, Jana Christina Dahlhoff, Shumallah Basit, Ute Oltmanns, Gerhard Fuchs, Wolfgang Reikow, Claude Jabbour, Matthias Körner, Michael Müller, Alice Bernard, the PRiVENT-Study Group, Jens Müller, Nina Lutz, Timm Frerk, Nicola Litke, Christoph Rauch, Jens Regula, Ahmed Ehab, Sebastian Stier, Michel Wensing, Christoph Schlegel, Sergej Markin
article en

Abstract

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.

Critical Care
Heidelberg University (DE), University Hospital Heidelberg (DE), Robert Bosch Hospital (DE), Löwenstein Medical (Germany) (DE), Universitätsklinikum Tübingen (DE), German Centre for Cardiovascular Research (DE), German Center for Lung Research (DE), Waldburg-Zeil Kliniken (DE), University Medical Centre Mannheim (DE), Medizinische Fakultät Mannheim, University of Tübingen (DE)
Good health and well-being
Openalex Percentile: Top 12%
Respiratory Support and Mechanisms
DOIOpen Access PDFOpenAlex
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