Respiratory failure & ventilation
Integrated comprehensive assessment for predicting weaning success in difficult-to-wean critically ill patients: the WEAN-US study
Authors' conclusion
In difficult-to-wean patients, SBT failure and weaning failure are driven by several interacting physiological mechanisms. A multimodal, ultrasound-based approach integrating cardiac, pulmonary, diaphragmatic, and neuromuscular domains improves prediction of weaning outcomes
Study context
- Population
- Adult difficult-to-wean patients (≥ 48 h of mechanical ventilation (MV) and failure of the first separation attempt) undergoing a standardized spontaneous breathing trial (SBT)
- Exposure
- Integrated multimodal ultrasound-based model vs individual physiological predictors
- Outcome
- Prediction of weaning failure (inability to wean or post-extubation failure)
Methodological detailssingle-centre, prognostic model (Least Absolute Shrinkage and Selection Operator (LASSO) regression)
- Single-centre
- Prognostic model (LASSO regression)
Main finding
As reported in the abstract
Weaning failure
Weaning failure incidence
27%
Integrated model AUROC (95% CI 0.78-0.95), outperforming individual predictors
0.88
Observational data: associations, not effects.
Secondary outcomes
- Cardiac parameters (higher E/e' and ejection fraction) associated with SBT failure; neuromuscular impairment more strongly associated with post-extubation failure
Original publication
Integrated comprehensive assessment for predicting weaning success in difficult-to-wean critically ill patients: the WEAN-US study. Crit Care. Published 4 June 2026. doi:10.
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