Respiratory failure & ventilation
Incidence and risk factors of weaning-induced pulmonary oedema: results from a multicentre, observational study
Authors' conclusion
In general ICU patients, WIPO accounts for 36% of weaning failure cases. Previous heart disease and COPD are two independent risk factors for developing WIPO during the weaning process.
Study context
- Population
- Adult critically ill patients on invasive ventilation undergoing an spontaneous breathing trial (SBT), 13 ICUs in France, Italy and IndiaSBTs in 500 patients
- Participants
- 634 patients
- Exposure
- T-piece vs PSV-PEEP vs PSV-ZEEP
- T-piecen = 358reference
- PSV-PEEPn = 84
- PSV-ZEEPn = 192
- Outcome
- Incidence of weaning-induced pulmonary oedema (WIPO; consensual diagnosis a posteriori by five experts)
Methodological detailsmulticentre, international (France, Italy, India), SBT changes retrospectively recorded, July 2019 to February 2021, retrospectively registered on 2022-03-31
- Multicentre
- International (France, Italy, India)
- SBT changes retrospectively recorded
- July 2019 to February 2021
- Retrospectively registered on 2022-03-31
Main finding
As reported in the abstract
WIPO incidence
PSV-PEEP vs T-piece: P = 0.072 · PSV-ZEEP vs T-piece: P = 0.002
- Weaning-induced pulmonary oedema (WIPO) diagnosed overall (of 634 SBTs)
- 79 (12%)
- Share of the 217 weaning failures due to WIPO
- 36%
Observational data: associations, not effects.
Further findings
Weaning outcome
- Weaning success
- 417 (66%)
- Weaning failure
- 217 (34%)
- Short weaning (SBTs)
- 414 (83%)
- Difficult weaning (SBTs)
- 47 (9%)
- Prolonged weaning (SBTs)
- 39 (8%)
Independent risk factors for WIPO (multilevel logistic regression, 202 weaning failures in 149 patients)
- COPD and previous cardiomyopathy identified as independent risk factors associated with WIPO
Original publication
Incidence and risk factors of weaning-induced pulmonary oedema: results from a multicentre, observational study. Crit Care. Published 31 March 2025. doi:10.
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