Proper Early Weaning from Ventilator Assistance Influences the Overall Survival of Patients with Severe Burns: A Case-Control Study.

Abstract

Background: Ventilator assistance is crucial in the treatment of severely burned patients. However, there is no consensus on the optimal duration of ventilator assistance, and whether it has an impact on the short - and long-term prognosis of severely burned patients is still unclear.

Methods: We incorporated 185 severely burned patients in our study. Kaplan-Meier analysis and Chi-square tests were applied to reveal the associations of days of ventilator assistance with patients' overall survival (OS) and other clinical variables. Multivariable Cox regression was applied, and the model was diagnosed by residual analysis, calibration curve analysis, decision curve analysis, and receiver operating characteristic curve analysis. 144 burned patients in Changhai Cohort were used for external validation.

Results: Ventilator assistance > 26 days was significantly associated with a shorter OS in severely burned patients (P-value < 0.001). Besides, "days of ventilator assistance" was significantly correlated with the burn area (P-value < 0.001), and the combination of inhalation injury (P-value < 0.01), sepsis, DIC, AHF, AKI, ALF, and ARDS (P-value < 0.001). The prognostic value of "days of ventilator assistance" was further validated in Changhai Cohort.

Conclusion: Prolonged ventilator assistance was associated with decreased OS in severely burned patients. Under the premise of the recovery of spontaneous respiratory function, early weaning from ventilator assistance might improve the prognosis of patients with severe burns. The findings on the optimal duration of ventilator assistance and its impact on survival in severely burned patients would interest healthcare professionals in respiratory and critical care medicine.