Factores de riesgo asociados al destete ventilatorio fallido en pacientes sépticos en una unidad de cuidado intensivo: estudio de casos y controles

Introduction: Several risk factors of failed weaning from mechanical ventilation may present in septic patients requiring invasive ventilatory support. Objective: To determine the risk factors associated with weaning failure in septic patients admitted to an intensive care unit (ICU) in Cali, Colombia, between January 2014 and June 2018. Materials and methods: Case-control study conducted in 315 patients who required mechanical ventilation for more than 48 hours, and distributed as follows, 105 cases (failed weaning) and 210 controls (successful weaning). Information about sociodemographic and clinical variables was obtained from their medical records. A bivariate analysis was performed to determine the association between each independent variable and failed weaning; also, a multivariate analysis was carried out using a logistic regression model in which the variables with a p value <0.20 in the bivariate analysis were entered. A significance level of p≤0.05 was considered. Results: Having required mechanical ventilation for more than 7 days (OR: 15.1; 95%CI: 8.25-27.74), having a high APACHE II score on ICU admission (OR: 3.16; 95%CI: 1.73-5.77), and diuresis ≤0.5cc/kg/h (OR: 1.87; 95%CI: 1.0-3.50) were significantly associated with weaning failure. Conclusions: Having required mechanical ventilation for more than 7 days, having diuresis ≤0.5ml/kg/h and a high APACHE ll score on ICU admission were risk factors for failed weaning from mechanical ventilation in the study population; however, age, blood urea nitrogen, creatinine, and positive fluid balance were not associated with it, despite they have been described as risk factors in the literature.