Influence of clinical severity and ventilation time on the use of timed inspiratory effort (TIE) as a predictor of success in ventilatory weaning.

Abstract

Background: Weaning from mechanical ventilation (MV) is a critical phase in the recovery of patients undergoing prolonged ventilation. Previous studies have suggested the timed inspiratory effort (TIE) index as a potential predictor of weaning success. This study aimed to evaluate the predictive value of TIE and the impact of clinical severity and ventilation time on weaning outcomes.

Methods: A prospective observational study was conducted in patients undergoing prolonged MV. Analysis included TIE measurements, duration of MV, and clinical severity as assessed by the Simplified Acute Physiology Score 3 (SAPS3). Logistic regression and receiver operator characteristic (ROC) curve analyses were performed to determine the predictive value of TIE for weaning success. All statistical tests were performed with a significance level of P<0.05.

Results: TIE showed limited utility as an independent predictor of weaning success, with an area under the ROC curve (AUC) of 0.529 and a non-significant P value (P=0.79). In contrast, clinical severity as measured by the SAPS3 score was a significant predictor of weaning success (P=0.01). Patients with lower SAPS3 scores were more likely to be weaned successfully.

Conclusions: TIE as an isolated tool is limited in predicting successful weaning from MV. Clinical severity, as assessed by tools such as the SAPS3 score, appears to be more relevant. Integrating multiple clinical parameters into decision models may improve weaning outcomes in ventilated patients.