Respiratory failure & ventilation
Distinct weaning phenotypes in patients unsuccessful in weaning from invasive mechanical ventilation: a secondary analysis of the WEAN SAFE cohort
Authors' conclusion
Three weaning failure phenotypes were identified with distinct clinical profiles, weaning trajectories, and outcomes.
Study context
- Population
- Patients on invasive mechanical ventilation (MV) who enter the weaning process but fail to wean
- Participants
- 5,664 patients
- Comparison
- Failed-Wean vs Successful-Wean
- Failed-Weann = 664
- Successful-Weann = 3,730reference
- No separation attempt (SA)n = 1,270
- Primary endpoint
- ICU mortality
Primary result
As reported in the abstract
Further findings
Duration of invasive ventilation and ICU LOS
- Failed-Wean had the longest duration of invasive ventilation and longest ICU stay of all groups
Weaning process
- Failed-Wean vs Successful-Wean: more SAs, fewer attempted extubations, more reintubations and tracheostomies
Failed-Wean phenotypes
- Three phenotypes: A (single SA + WLST), B (single SA, no WLST), C (> 1 SA)
- Failed first SA strongly associated with WLST decisions
- WLST decision associated with higher hazard of ICU mortality and shorter median time to ICU death
Original publication
Distinct weaning phenotypes in patients unsuccessful in weaning from invasive mechanical ventilation: a secondary analysis of the WEAN SAFE cohort. Intensive Care Med. Published 9 September 2026. doi:10.
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