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A "Politically Robust" Experimental Design for Public Policy Evaluation, with Application to the Mexican Universal Health Insurance Program
- Author
- Publication venue
- 'Wiley'
- Publication date
- 14/06/2010
- Field of study
We develop an approach to conducting large scale randomized public policy experiments intended to be more robust to the political interventions that have ruined some or all parts of many similar previous efforts. Our proposed design is insulated from selection bias in some circumstances even if we lose observations; our inferences can still be unbiased even if politics disrupts any two of the three steps in our analytical procedures; and other empirical checks are available to validate the overall design. We illustrate with a design and empirical validation of an evaluation of the Mexican Seguro Popular de Salud (Universal Health Insurance) program we are conducting. Seguro Popular, which is intended to grow to provide medical care, drugs, preventative services, and financial health protection to the 50 million Mexicans without health insurance, is one of the largest health reforms of any country in the last two decades. The evaluation is also large scale, constituting one of the largest policy experiments to date and what may be the largest randomized health policy experiment ever.Governmen
Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV
- Author
- Aarrestad Thea Klaeboe
- Aarup Petersen Henriette
- Abbaneo Duccio
- Abbiendi Giovanni
- Abbrescia Marcello
- Abdullin Salavat
- Abercrombie Daniel
- Abreu A.
- Acharya Himal
- Acosta Darin
- Adam Wolfgang
- Adamidis K.
- Adams Eric
- Adams Mark Raymond
- Adams Todd
- Addesa Francesca Maria
- Adloff Catherine
- Adzic Petar
- Afanasiev Serguei
- Agapitos Antonis
- Agarwal Garvita
- Aggleton Robin
- Agram Jean-Laurent
- Aguilar-Benitez Manuel
- Ahmad Ashfaq
- Ahmad Muhammad
- Ahmed Asar
- Ahuja Sudha
- Aime` Chiara
- Aime‘ C.
- Akchurin Nural
- Akgun Bora
- Akpinar Alp
- Albergo Sebastiano
- Albert Andreas
- Albrecht Steffen
- Albrow Michael
- Alcaraz Maestre Juan
- Aldaya Martin Maria
- Aldá Júnior Walter Luiz
- Aleksandrov Aleksandar
- Alexander James
- Alhusseini Mohammad
- Alimena Juliette
- Alison John
- Almond John
- Alpana Km
- Alvarez Gonzalez Barbara
- Alverson George
- Alves Gallo Pereira Miguel
- Alves Gilvan
- Aly Reham
- Alyari Maral
- Amapane Nicola
- Ambrozas Marijus
- Amendola Chiara
- Amin Nick
- Amram Oz
- Amsler Claude
- An Sitong
- An Ying
- Anagnostou Georgios
- Andrea Jeremy
- Andreassi Guido
- Andreev Vladimir
- Andreev Yu.
- Andreev Yuri
- Andrejkovic Janik Walter
- Andrews Michael Benjamin
- Androsov Konstantin
- Anguiano J.
- Antchev Georgy
- Anthony David
- Antunovic Zeljko
- Apollinari Giorgio
- Apparu Dylan
- Appelt Eric
- Apresyan Artur
- Apyan Aram
- Araujo Mariana
- Arcaro Daniel
- Arcidiacono Roberta
- Arenton Michael Wayne
- Argiro Stefano
- Arneodo Michele
- Aruta Caterina
- Asavapibhop Burin
- Asawatangtrakuldee Chayanit
- Asenov Patrick
- Asghar Muhammad Irfan
- Asilar Ece
- Askew Andrew
- Asmuss Paul
- Atakisi Ismail Okan
- Attikis Alexandros
- Auffray Etiennette
- Aushev Tagir
- Auzinger Georg
- Avati Valentina
- Avery Paul
- Avila Carlos
- Awais Ali
- Awan Muhammad Imran Malik
- Ayala Edy
- Ayala Gabriel
- Azarkin Maksim
- Azhgirey Igor
- Aziz Tariq
- Azzi Patrizia
- Azzurri Paolo
- Baarmand Marc M
- Babaev Anton
- Bacchetta Nicola
- Bachiller Irene
- Bachtis Michail
- Backhaus Malte
- Baden A.
- Baden Drew
- Baechler Joachim
- Bagliesi Giuseppe
- Bahinipati Seema
- Baillon Paul
- Bainbridge Robert
- Bakas Georgios
- Bakhshiansohi Hamed
- Bakshi Amandeep Singh
- Baldenegro Barrera Cristian
- Ban Yong
- Band Reyer
- Bandyopadhyay Hirak
- Banerjee Sudeshna
- Banerjee Sunanda
- Bansal Sunil
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- Barberis Emanuela
- Bargassa Pedrame
- Baringer Philip
- Barnes Virgil E
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- Bayatmakou M.
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- Breedon Richard
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- Christoforou K.
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- Scheurer Valerie
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- Yuldashev Bekhzod S
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- Yusli Mohd Nizam
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- Zacharopoulou Anna
- Zahid Sema
- Zaleski Shawn
- Zalewski Piotr
- Zanetti Marco
- Zarubin Anatoli
- Zarucki Mateusz
- Zecchinelli Angelo Giacomo
- Zeinali Maryam
- Zeuner Wolfram Dietrich
- Zghiche Amina
- Zhang Fengwangdong
- Zhang Huaqiao
- Zhang Jingyu
- Zhang Liuyao
- Zhang Wenyu
- Zhang Yi
- Zhang Yousen
- Zhang Zhicai
- Zhao Jingzhou
- Zhizhin Ilia
- Zhokin Alexander
- Zhu De Hua
- Zhu Ren-Yuan
- Ziemons Tim
- Zoi Irene
- Zolkapli Zukhaimira
- Zorbakir Ibrahim Soner
- Zorbilmez Caglar
- Zotto Pierluigi
- Zotz Alexander
- Zou David
- Zou Rui
- Zucchetta Alberto
- Zumerle Gianni
- Zuo Xunwu
- Zuolo Davide
- Zygala Lara
- Álvarez Fernández Adrian
- Özçelik Özlem
- Publication venue
- Publication date
- 01/01/2021
- Field of study
A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
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- Aktokmakyan Talar Vartanoglu
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- Al-Badawi Ismail A.
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- Kauppila Joonas H
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- Kealey Joshua
- Kebede Ephrem
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- Ladipo-Ajayi Oluwaseun
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- Li Elizabeth
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- Liang Rhea
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- Lohmann Tibor Karl
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- Lyra Humberto Fenner
- Mabood Waleed
- MacChiavello Roberto
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- Maguire Patrick J.
- Mahečić Tina Tomić
- Mahmood Fahad
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- Mahmud Ayesha
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- Mannan Syed
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- Martins Paulo N.
- Martínez Daniel Fernández
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- Matthews Emily
- Mauriello Claudio
- Maurus Christine
- Mayer Horacio F.
- Mayo-Yáñez Miguel
- Mazzarella Gennaro
- Mbodi Langanani
- Mbwele Bernard
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- McGrath John
- McKay Joseph
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- McLeish Bethan
- McPherson Duncan
- Meara John G.
- Meead Adullah
- Mehraj Asif
- Meilak Joseph
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- Mengesha Mengistu G.
- Menna Maria Paola
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- Modabber Ali
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- Mohamedahmed Ali Yasen Y.
- Mohammed Alhassan Datti
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- Myrelid Par
- Myriokefalitaki Eva
- Méndez Patricia Serrano
- Nabil Fatma
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- Nacion Aeris Jane D.
- Nadi Khaldoun
- Naegele Felix
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- Nah Shireen Anne
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- Naranjo Eddy P. Lincango
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- Nassar Mahmoud A.
- Nasser Sara
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- Newman Samuel
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- Niewiera Marc
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- Nitschke Christine
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- Novysedlák René
- Ntalouka Maria P.
- Ntirenganya Faustin
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- Nuhu Ahmed Mohammed
- Nunes Rafael Leite
- Nuñez Jorge
- Nwafor Ikechuwu
- Nyarko Obed Ofori
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- O'Connell Robert Michael
- O'Connor Alexander
- O'Dwyer Marliza
- O'Riordan James
- Odai Emeka Danielson
- Odicino Franco
- Ofori Emmanuel Owusu
- Ogu Rosemary
- Ogundoyin Olakayode
- Ogundoyin Oluwole
- Oh Ke En
- Ohazurike Ephraim
- Ojewuyi Olufemi
- Ojo Owolabi
- Okere Oghenekevwe
- Okereke Chukwuma
- Okhakhu Amina
- Okpani Charles
- Oktseloglou Vlasios
- Okunade Kehinde
- Oladimeji Abraham
- Olaogun Julius
- Oliver Isabel Mora
- Olivos Maricarmen
- Olori Samson
- Olson Kristofor A.
- Oludara Mobolaji
- Omar David
- Omar Islam
- Omer Mohammed Eltahier Abdalla
- Ong Chon Sum
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- Onyemaechi Ndubuisi
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- Slavchev Mihail
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- Smith A.
- Smolle-Juettner Freyja-Maria
- Sodhai Vivek
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- Sokolov Manol
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- Sole-Sedeno Josep M.
- Soljic Martina
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- Soon Wai Cheong
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- Spellar Kayleigh
- Spiers Harry V. M.
- Spina Alfio
- Spriano Giuseppe
- Squiers John
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- Starr Nichole
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- Stewart Grant D.
- Stijns Jasper
- Stogowski Piotr Tomasz
- Stoleriu Mircea Gabriel
- Stoyanov Vladislav
- Street John
- Strotmann Johanna Josefine
- Stroumpoulis Konstantinos
- Su Yu-Xiong
- Suarez Sara Busto
- Subramani Yamini
- Subramaniam Sentilnathan
- Sue-Chue-Lam Colin
- Suer Muhammed Salih
- Sulaiman Bilal
- Sultania Mahesh
- Sundarraju Shalini
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- Tamburello Sara
- Tamini Nicolò
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- Tarek Ahmed
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- Tatsis Dimitris
- Tawalbeh Ra'Fat
- Tawiah Augustine
- Tebha Sameer
- Techapongsatorn Suphakarn
- Teixeira Pedro
- Tejero-Pintor Francisco J.
- Tellez Karla Susana Martin
- Tellez Luis Garcia-Sancho
- Thaha Mohamed Adhnan
- Thakar Sumit
- Thaw May Htoo
- Theivendran Kanthan
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- Theodoropoulos George
- Theophilidou Elena
- Thereska Dariel
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- Thomas Bradley
- Thomas Jerin Jose
- Thuduvage Vasanthika
- Thumbadoo Ruben
- Tian Sarah
- Tidjane Anisse
- Tirloni Luca
- Toia Francesca
- Tokidis Evripidis
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- Tolani Musliu Adetola
- Toma Elena Adelina
- Tomasicchio Giovanni
- Tomlinson James
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- Torre Beatrice
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- Tousidonis Manuel
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- Tranca Sebastian
- Trebol Jacobo
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- Trifunovski Aleksandar
- Tripathi Manjul
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- Tucker Olga
- Tuech Jean Jacques
- Turan Alparslan
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- Turri Giulia
- Tutino Roberta
- Tuyishime Eugene
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- Valeanu Liana
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- Valladares Sergio Chávez
- Vallve-Bernal Marc
- Van Acker Jill
- Van Den Eynde Jef
- Van Goor Harry
- Van Vliet Helen
- Van Wyk Naomi Natasha
- Vanni Camilla
- Vas Aurelia
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- Vaschetti Roberto
- Vassiliu Panteleimon
- Vatansever Dogan
- Vatish Jamie
- Vaughan-Shaw Peter G.
- Vaysburg Dennis
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- Velázquez Maria Jose Martinez
- Venkatappa Sunil Kumar
- Venketeswaran Meenakshi
- Venskutonis Donatas
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- Verdi Daunia
- Vergara-Fernandez Omar
- Verhoeff Kevin
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Verre Luigi
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- Viglietta Edoardo
- Vijay Vardhini
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- Vilaró Blanca Capdevila
- Villanueva Julio
- Vilz Tim O.
- Vincent Elizabeth
- Vinci Danilo
- Viola Simona
- Violante Tommaso
- Vishnoi Jeewan Ram
- Vissapragada Ravi
- Vivancos Laura Guillamon
- Vives Josep Maria Muñoz
- Vizzielli Giuseppe
- Vohra Lubna
- Vokshi Ismail
- Vosinakis Christos
- Vásquez Javier Alberto Gutiérrez
- Vázquez Gil
- Vázquez Irene Ortega
- Vǎcǎraşu Andrei Bogdan
- Wade Ryckie
- Wafi Omar
- Wagner Gabriela
- Wallis Christopher
- Wanjara Samuel
- Waqar Shahzad Hussain
- Warden Claire
- Warner Christian
- Wasim D.
- Wason Shaun
- Wasserman Isaac
- Watcyn-Jones Tom
- Waterson Ben
- Watson David
- Watson Matthew
- Weber Clemens
- Wheatstone P.
- Wheeler James
- Wheldon Luke
- White Michelle
- White Stuart
- White William
- Wickramasinghe Dakshitha
- Widmer Lukas Werner
- Wiedemann Dominik
- Wiesinger Clemens Georg
- Wijekoon Naveen
- Wijenayake Wasantha
- Wijeyaratne Manuk
- Wijeysundera Duminda
- Wiles Matthew
- Wilkin Richard
- Wilkins Alex
- Wilkins James
- William Tinka George
- Williams Omolara Modupe
- Williams Shekinah
- Windsor John
- Winnand Philipp
- Wittmann Maria
- Wolde Amanuel
- Wolfenden John W. D.
- Wong Benjamin Ngie Xiong
- Wong Enoch
- Wong Evan G.
- Wong George Kwok Chu
- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
- Wright Deborah
- Wright Joshua
- Wu Fiona
- Wurm Markus
- Xenaki Sofia
- Yadev Ip
- Yahaya Ahmad Shuib
- Yakubu Mustapha
- Yang Wah
- Yanik Özge
- Yanowsky-Reyes Guillermo
- Yassin Abubaker
- Yates Elizabeth
- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Reporte de actividades del Viaje a Jamaica como ponente en IAI Training Institute on Climate and Health, Nov. 7-18 en Kingston, Jamaica
- Publication venue
- Publication date
- 01/01/2005
- Field of study
Knowledge and beliefs about malaria transmission and practices for vector control in Southern Mexico
- Author
- Publication venue
- 'Instituto Nacional de Salud Publica'
- Publication date
- Field of study
Objective. To investigate the knowledge and beliefs about malaria transmission and practices for vector control in eight villages on the coastal plain of Chiapas, Mexico. Material and Methods. A cross-sectional survey was conducted during May and June 1995 in Chiapas, Mexico. A questionnaire to investigate family structure, knowledge on malaria transmission, preventive measures and attitudes towards seeking treatment was applied to both family heads of a sample of households. Associations were analyzed by estimating odds ratios with confidence intervals and p values, using bivariate and multivariate logistic regression methods. Results. Malaria knowledge was poor and only 48% associated malaria with mosquito bites. The perceived benefit of indoor residual spraying was associated to a reduction of mosquitoes, a reduction in the numbers of cockroaches and rats, but only 3% associated it directly with the prevention of malaria transmission. Most villagers (97.6%) agreed with the indoor residual spraying of insecticides. Ninety nine percent of villagers had mosquito bednets, 75.7% used them all year round. Other measures used by villagers to prevent mosquito bites were smoke and mosquito coils. Above 40% of villagers self-medicated when any member of the family had a fever episode, but 51% attended proper health services (community dispensary, private physician, health worker). About 61% used pesticides for agricultural or livestock purposes and 55% applied them themselves. Women had a greater participation as family health promoters, with 70% of the housewives being in charge of the application of self-protection preventive measures. Conclusions. Educational programs aimed at increasing awareness on the participation of mosquitoes on malaria transmission could promote community participation in malaria control in the region. The English version of this paper is available too at: http://www.insp.mx/salud/index.html
Comparative analysis of two alternative models for epidemiological surveillance in the Mexican Malaria Control Program
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One-carbon metabolism nutrient intake and the association between body mass index and urinary arsenic metabolites in adults in the Chihuahua cohort
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- Ahsan
- Blanca Sánchez-Ramirez
- Calderon
- Carmen González-Horta
- Chen
- Chen
- Chen
- Chen
- Currier
- Da Silva
- Denova-Gutierrez
- Douillet
- Farzan
- Farzan
- Gamble
- Gamble
- Gomez-Caminero
- Gomez-Rubio
- Gonzalo G. García-Vargas
- Grau-Perez
- Grau-Perez
- Gribble
- Gribble
- Hall
- Heck
- Hernandez-Avila
- Hernandez-Zavala
- Hijazi
- Huang
- Hudgens
- IARC
- Institue of Medicine Food and Nutrition Board
- Jansen
- Juan Eugenio Hernández Ávila
- Kuo
- Kuo
- Lindberg
- Lourdes Ballinas-Casarrubias
- Lu
- Luz M. Del Razo
- Marseglia
- Melak
- Mendez
- Michelle A. Mendez
- Mier-Cabrera
- Mirek Stýblo
- Naujokas
- NIH Office of Dietary Supplements
- NIH Office of Dietary Supplements
- NIH Office of Dietary Supplements
- Nizam
- Paige A. Bommarito
- Peters
- Peters
- Peters
- Pierce
- Quansah
- Rahman
- Rebecca C. Fry
- René Santos Luna
- Romieu
- Rothman
- Salazar-Martinez
- Sanchez
- Shen
- Shim
- Shockley
- Spratlen
- Spratlen
- Steinmaus
- Steinmaus
- Susana Román Pérez
- Thomas
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- Tseng
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- WHO
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- Xiaofan Xu
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- Yu
- Zhang
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CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014
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- A Antinori
- Alfonso C. Hernández-Romieu
- Antonio Guilherme Pacheco
- Arredondo S Bautista
- B Aracena-Genao
- B Crabtree-Ramirez
- B Crabtree-Ramirez
- B Crabtree-Ramirez
- B Efron
- B Stanley
- C Chaumont
- C Infante
- C Smit
- C Wing
- Carlos del Rio
- CJ Hoffmann
- CM Carrizosa
- CR Lesko
- FM Knaul
- HI Hall
- Hugo Lopez-Gatell
- J Hernandez-Avila
- J Kaplan
- JA Fleishman
- José Antonio Izazola-Licea
- JP Gutiérrez
- JP Gutiérrez
- Juan Eugenio Hernández-Ávila
- K Sabapathy
- KN Althoff
- LR Metsch
- MA Colchero
- Mauricio Hernández-Ávila
- MJ Mugavero
- MJ Siedner
- MM Kitahata
- N Siegfried
- NM Zetola
- O Gómez Dantés
- Patricia Uribe Zúñiga
- PG Farnham
- S Bautista-Arredondo
- S Bautista-Arredondo
- S Desai
- S Kiertiburanakul
- S Moreno
- SM Goldenberg
- T Kendall
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Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study
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- Abe Toshikazu
- Aboshady Abdelrhman
- Abrough Fekri
- Acampo-de Jong Melanie
- Acharya Subhash
- Acharya Subhash P
- Adderley Jane
- Adiguzel Nalan
- Agrawal Vijay Kumar
- Aguilar Gerardo
- Aguirre Gaston
- Aguirre-Bermeo Hernan
- Ahlström Björn
- Akbas Türkay
- Akker Mustafa
- Al Sadeh Ghamdan
- Alamri Sultan
- Algaba Angela
- Ali Muneeb
- Aliberti Anna
- Allegue Jose Manuel
- Alvarez Diana
- Amador Joaquin
- Amin Pravin
- Andersen Finn H
- Ansari Sharique
- Apichatbutr Yutthana
- Apostolopoulou Olympia
- Arabi Yaseen
- Arabi Yaseen
- Aragao Irene
- Aragao Irene
- Arellano Daniel
- Arica Mestanza
- Arikan Huseyin
- Arinaga Koichi
- Arnal Jean-Michel
- Asano Kengo
- Asín-Corrochano Marta
- Avalos Cabrera Jesus Milagrito
- Avila Fuentes Silvia
- Aydemir Semih
- Aygencel Gulbin
- Azevedo Luciano
- Bacakoglu Feza
- Badie Julio
- Baedorf Kassis Elias
- Bai Gabriela
- Balaraj Govindan
- Ballico Bruno
- Banner-Goodspeed Valerie
- Banwarie Preveen
- Barbieri Rosella
- Baronia Arvind
- Barrett Jonathan
- Barrot Loïc
- Barrueco-Francioni Jesus Emilio
- Barry Jeffrey
- Bauer Philippe
- Bauer Philippe
- Bawangade Harshal
- Beavis Sarah
- Beck Eduardo
- Beduneau Gaëtan
- Beduneau Gaëtan
- Beehre Nina
- Beitler Jeremy
- Belenguer Muncharaz Alberto
- Bellani Giacomo
- Bellani Giacomo
- Belliato Mirko
- Bellissima Agrippino
- Beltramelli Rodrigo
- Ben Souissi Asma
- Benitez-Cano Adela
- Benlamin Mohamed
- Benslama Abdellatif
- Bento Luis
- Benvenuti Daniela
- Berkius Johan
- Berkius Johan
- Bernabe Laura
- Bersten Andrew
- Berta Giacomo
- Bertini Pietro
- Bertram-Ralph Elliot
- Besbes Mohamed
- Bettini Lisandro Roberto
- Beuret Pascal
- Bewley Jeremy
- Bezzi Marco
- Bhakhtiani Lakshay
- Bhandary Rakesh
- Bhowmick Kaushik
- Bihari Shailesh
- Bissett Bernie
- Blythe David
- Bocher Simon
- Boedjawan Narain
- Bojanowski Christine M
- Boni Elisa
- Boraso Sabrina
- Borelli Massimo
- Borello Silvina
- Borislavova Margarita
- Bosma Karen J
- Bottiroli Maurizio
- Boyd Owen
- Bozbay Suha
- Briva Arturo
- Brochard Laurent
- Brochard Laurent
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- Bruni Andrea
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- Bugedo Guillermo
- Bugedo Guillermo
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- Castelli Antonio
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- Cereijo Enrique
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- Ceunen Helga
- Chaintoutis Christos
- Chang Youjin
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- Chelazzi Cosimo
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- Clarkson Kevin
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- Elatrous Souheil
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- Elsaadany Mohamed
- Elsayed Hany
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- Englert Joshua A
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- Galeas-Lopez Juan Luis
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- Goligher Ewan C
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- Gordillo Romero Orlando
- Gordo Federico
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- Grasselli Giacomo
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- Gritsan Alexey
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- Heunks Leo
- Heunks Leo M
- Hidalgo Juan
- Hill Dianne
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- Horner Daniel
- Hornos M Carmen
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- Hunter Stephanie
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- Laake Jon Henrik
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- Laffey John G
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- Leonor Tiago
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- Li Dahuan
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- Lind Dan
- Litton Edward
- Liu Jialin
- Liu Ling
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- Llorente Beatriz
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- Lopez Claudia Elizabeth
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- Martin Alex
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- Martinez Felipe
- Martínez-Fidalgo Conchita
- Mas Arantxa
- Masaaki Sakuraya
- Maseda Emilio
- Massa Eleni
- Matamis Dimitrios
- Mattsson Anna
- Maugeri Jessica
- McCredie Victoria
- McCullough James
- McGuinness Shay
- McKown Andrew
- Medve László
- Mei Chengqing
- Mellado Artigas Ricard
- Mendes Vitor
- Mervat Mohamed Khalaf Ebraheim
- Michaux Isabelle
- Mikhaeil Michael
- Milagros Olga
- Milet Igor
- Millan Maria Teresa
- Minwei Zhang
- Mirabella Lucia
- Mishra Sanghamitra
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- Moerer Onnen
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- Molnar Zsolt
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- Motherway Catherine
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- Parrilla Francisco J
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- Peñuelas Oscar
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- Philippart François
- Picetti Edoardo
- Pierucci Elisabetta
- Piervincenzi Edoardo
- Pinciroli Riccardo
- Pintado Maria-Consuelo
- Piquilloud Lise
- Piquilloud Lise
- Piquilloud Lise
- Piraino Thomas
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- Platas Enrique
- Plotnikow Gustavo
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- Portilla Mariana
- Portugal José
- Povoa Pedro
- Prat Gwenael
- Pratto Romina
- Preda Gabriel
- Prieto Isidro
- Prol-Silva Estefania
- Pugh Richard
- Pérez-Araos Rodrigo
- Qi Yupeng
- Qian Chuanyun
- Qin Tiehe
- Qiu Haibo
- Qiu Haibo
- Qu Hongping
- Quintana Teobaldo
- Quispe Sierra Rosari
- Quispe Soto Rocio
- Rabbani Raihan
- Rabee Mohamed
- Rabie Ahmed
- Rahe Pereira Maria Augusta
- Rai Ashish
- Raj Ashok Sundar
- Rajab Mostafa
- Ramdhani Navin
- Ramey Elizabeth
- Ranieri Marco
- Rathod Darshana
- Ray Banambar
- Razek Assem Abdel
- Redwanul Huq Shihan Mahmud
- Regli Adrian
- Reina Rosa
- Resano Sarmiento Natalia
- Reynaud Faustine
- Rialp Gemma
- Ricart Pilar
- Rice Todd
- Richardson Angus
- Rieder Marcelo
- Rinket Martin
- Rios Fernando
- Rios Fernando
- Risso Vazquez Alejandro
- Rittayamai Nuttapol
- Rittayamai Nuttapol
- Riva Ivano
- Rivette Monaly
- Roca Oriol
- Roche-Campo Ferran
- Rodriguez Gonzalez Daniel
- Rodriguez Tucto Xandra Yanina
- Rodriguez Covadonga
- Rodriguez Gabriel
- Rogers Angela
- Roldan Rollin
- Romano María Elena
- Rose Alastair
- Roux Damien
- Rouze Anahita
- Rubatto Birri Paolo Nahuel
- Ruilan Wang
- Ruiz Robledo Aldana
- Ruiz-Aguilar Antonio Luis
- Rørtveit Linda
- Sadahiro Tomohito
- Saez Ignacio
- Sagardia Judith
- Saha Rajnish
- Saha Rohit
- Saiphoklang Narongkorn
- Saito Shigeki
- Salem Maie
- Sales Gabriele
- Salgado Patricia
- Samavedam Srinivas
- Sami Mebazaa Mhamed
- Samuelsson Line
- San Juan Roman Nandyelly
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- Sanchez-Ballesteros Jesus
- Sandoval Yazcitk
- Sani Emanuele
- Santos Carla
- Santos Martin
- Sanui Masamitsu
- Saravanabavan Lakshmikanthcharan
- Sari Sema
- Sarkany Agnes
- Sauneuf Bertrand
- Savioli Monica
- Sazak Hilal
- Scano Riccardo
- Schneider Francis
- Schortgen Frédérique
- Schultz Marcus J
- Schwarz Gabriele Leonie
- Seely Andrew
- Seiler Frederik
- Seker Tekdos Yasemin
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- Serednicki Wojciech
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- Serpa Neto Ary
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- Shapovalov Konstantin
- Shebl Eman
- Shiga Takuya
- Shime Nobuaki
- Shin Phil
- Short Jack
- Shuhua Chen
- Siddiqui Sughrat
- Silesky Jimenez Juan Ignacio
- Silva Sales Betania
- Silva Daniel
- Simons Koen
- Sjøbø Brit Ågot
- Slessor David
- Smiechowicz Jakub
- Smischney Nathan
- Smith Mark
- Smith Paul
- Smith Tim
- Snape Sarah
- Snyman Lindi
- Soetens Filiep
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- Souloy Xavier
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- Stevenson Elizabeth
- Strand Kristian
- Strano Maria Teresa
- Straus Slavenka
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- Sundaram Venkat
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- Szuldrzynski Konstanty
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- Takaba Akihiro
- Tallott Mandy
- Talmor Daniel
- Tamasato Tamasato
- Tang Zhanhong
- Tangsujaritvijit Viratch
- Taniguchi Daisuke
- Taniguchi Leandro
- Tarantino Fabio
- Teerapuncharoen Krittika
- Temprano Susana
- Terragni Pierpaolo
- Terzi Nicolas
- Thakur Anand
- Theerawit Pongdhep
- Thille Arnaud W
- Thomas Matt
- Thungtitigul Poungrat
- Thyrault Martial
- Tilouch Nejla
- Timenetsky Karina
- Tirapu Juna
- Todeschini Manuel
- Tomas Roser
- Tomaszewski Christian
- Tomescu Dana
- Tonetti Tommaso
- Tonnelier Alexandre
- Trinder John
- Trongtrakul Konlawij
- Truwit Jonathon
- Tsuei Betty
- Tulaimat Aiman
- Turan Sema
- Turkoglu Melda
- Tyagi Sanjeev
- Ubeda Alejandro
- Vagginelli Federica
- Valenti María Florencia
- Vallverdu Imma
- Van Axel Alisha
- van den Hul Ingrid
- van der Hoeven Hans
- Van Der Meer Nardo
- van Haren Frank
- Van Haren Frank
- Van Haren Frank
- Vanhoof Marc
- Vargas-Ordoñez Mónica
- Vaschetto Rosanna
- Vascotto Ettore
- Vatsik Maria
- Vaz Ana
- Vazquez-Sanchez Antonia
- Ventura Sara
- Vermeijden Jan Wytze
- Vidal Anxela
- Vieira Jocyelle
- Vilela Costa Pinto Bruno
- Villagomez Asisclo
- Villagomez Asisclo
- Villagra Ana
- Villegas Succar Cristina
- Vinorum Ole Georg
- Vitale Giovanni
- Vj Ramesh
- Vochin Ana
- Voiriot Guillaume
- Volta Carlo Alberto
- von Seth Magnus
- Wajdi Maazouzi
- Walsh Don
- Wang Shouhong
- Wardi Gabriel
- Ween-Velken Nils Christian
- Wei Bi-Lin
- Weller Dolf
- Welsh Deborah
- Welters Ingeborg
- Wert Michael
- Whiteley Simon
- Wilby Elizabeth
- Williams Erin
- Williams Karen
- Wilson Antoinette
- Wojtas Jadwiga
- Won Huh Jin
- Wrathall David
- Wright Christopher
- Wu Jian-Feng
- Wunsch Hannah
- Xi Guo
- Xing Zheng-Jiang
- Xu Hongyang
- Yamamoto Kotaro
- Yan Jie
- Yang Xiaobo
- Yates Elliot
- Yazicioglu Mocin Ozlem
- Ye Zhenglong
- Yildirim Fatma
- Yoshida Norifumi
- Yoshido Hector Higo Leon
- Young Lee Bo
- Yu Gong
- Yu Rongguo
- Yu Tao
- Yuan Boyun
- Yuangtrakul Nadwipa
- Yumoto Tetsuya
- Yun Xie
- Yáñez Julio
- Zakalik Graciela
- Zaki Ahmad
- Zalba-Etayo Begoña
- Zambon Massimo
- Zang Bin
- Zani Gianluca
- Zarka Jonathan
- Zeggwagh Amine Ali
- Zerbi Simone Maria
- Zerman Avsar
- Zetterquist Harald
- Zhang Guoxiu
- Zhang Hongwen
- Zhang Jiuzhi
- Zhang Wei
- Zhang Weixin
- Zhao Hongsheng
- Zheng Jia
- Zhu Bin
- Zumaran Ronald
- Çukurova Zafer
- Öveges Nándo
- Özyilmaz Ezgi
- Publication venue
- 'Elsevier BV'
- Publication date
- 21/01/2023
- Field of study
Background
Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation.
Methods
WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109.
Findings
Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital.
Interpretation
In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates
Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study
- Author
- Abdelhamid Hachimi
- Abdellatif Benslama
- Abdelrhman Aboshady
- Abhijit Duggal
- Abidi Khalid
- Abubaker S Elmaryul
- Adela Benitez-Cano
- Adi Hadzibegovic
- Adrian Regli
- Agnes Sarkany
- Agnieszka Kubisz-Pudelko
- Agrippino Bellissima
- Agueda Ojados
- Ahmad Zaki
- Ahmed Rabie
- Aikaterini Dimoula
- Aiman Tulaimat
- Aitor Olmos
- Akihiro Takaba
- Akira Kuriyama
- Akram Khan
- Alastair Rose
- Alberto Belenguer Muncharaz
- Alberto Deicas
- Alberto Facchini
- Aldana Ruiz Robledo
- Alejandro Esquivel
- Alejandro Gonzalez-Castro
- Alejandro Risso Vazquez
- Alejandro Ubeda
- Alessandra Nasi
- Alex Martin
- Alexandre Molin
- Alexandre Tonnelier
- Alexey Gritsan
- Alexey Gritsan
- Alexis Jaspe Codecido
- Alfred Papali
- Alisha Van Axel
- Alistair Nichol
- Alma Cani
- Ameet Parekh
- Amine Ali Zeggwagh
- Amira Jamoussi
- Amy Collins
- Ana Raquel Lima
- Ana Vaz
- Ana Villagra
- Ana Vochin
- Anahita Rouze
- Anaid Manzano
- Analía Garcia
- Anand Thakur
- Anatilde Diaz
- Andrea Bruni
- Andrea Coppadoro
- Andrea Cortegiani
- Andrea Gabriela Peña Padilla
- Andrea Gigante
- Andrea Neville Cracchiolo
- Andrew Bersten
- Andrew Hermon
- Andrew McKown
- Andrew Seely
- Andrew Stapleton
- Andrey Gazenkampf
- Andrey Malyarchikov
- Angela Algaba
- Angela Rogers
- Angelo Giacomucci
- Angus Richardson
- Anil Hormis
- Anna Aliberti
- Anna Mattsson
- Antoinette Wilson
- Antonella Fortunato
- Antonella Frattari
- Antonia Vazquez-Sanchez
- Antonio Castelli
- Antonio Landaverde Lopez
- Antonio Luis Ruiz-Aguilar
- Anxela Vidal
- Aragao Irene
- Arantxa Mas
- Ariel Chena
- Arif Moghal
- Arnaud W Thille
- Aroa Gomez
- Arturo Briva
- Arvind Baronia
- Ary Serpa Neto
- Ary Serpa Neto
- Arzu Esen Tekeli
- Ashish K Khanna
- Ashish Rai
- Asim Shah
- Asisclo Villagomez
- Asisclo Villagomez
- Asma Ben Souissi
- Assem Abdel Razek
- Aude Garnero
- Aurélie Joret
- Avsar Zerman
- Ayca Gumus
- Ayse Nur Soyturk
- Banambar Ray
- Basanta Kumar Pati
- Beatriz Llorente
- Beduneau Gaëtan
- Begoña Zalba-Etayo
- Bellani Giacomo
- Benjamin Delmas
- Bernardo Panka
- Bernardo Panka
- Bernie Bissett
- Bertrand Sauneuf
- Betania Silva Sales
- Betty Tsuei
- Bhagyesh Shah
- Bi-Lin Wei
- Bin Zang
- Bin Zhu
- Björn Ahlström
- Bo Young Lee
- Bojan Jovanovic
- Bojan Jovanovic
- Borja Fernandez
- Boyun Yuan
- Brahim Housni
- Branislava Stefanovic
- Brit Ågot Sjøbø
- Brochard Laurent
- Bror Anders Johnstad
- Bruno Ballico
- Bruno Vilela Costa Pinto
- Candelaria de Haro
- Carla Santos
- Carlo Alberto Volta
- Carlo Oliveri
- Carlos Ferrando
- Carlos Munoz de Cabo
- Carlos Pellegrini
- Carmel Chapman
- Carmen Hernandez
- Caroline Kane
- Catalina Forteza
- Catherine Motherway
- Cecilia Eugenia Chavez
- Cenk Kirakli
- Ceri Lynch
- Cesar Perez Calvo
- Chen Jing
- Chen Shuhua
- Chengqing Mei
- Chenliang Sun
- Cherdkiat Karnjanarachata
- Christian Tomaszewski
- Christine M Bojanowski
- Christopher Tainter
- Christopher Wright
- Christos Chaintoutis
- Chrysi Diakaki
- Chuanyun Qian
- Clare Hammel
- Claude Guérin
- Claudia Elizabeth Lopez
- Claudia Lopez Nava
- Claudio Piras
- Colin Grissom
- Conchita Martínez-Fidalgo
- Cosimo Chelazzi
- Covadonga Rodriguez
- Cristina Coxo
- Cristina Martin Dal Gesso
- Cristina Villegas Succar
- Csaba Kopitko
- Cédric Bruel
- Cédric Daubin
- César Laborda
- Dagmar Holmquist
- Dahuan Li
- Daisuke Taniguchi
- Damien Roux
- Dan Lind
- Dana Tomescu
- Daniel Arellano
- Daniel Horner
- Daniel Moreno Torres
- Daniel Paul
- Daniel Rodriguez Gonzalez
- Daniel Silva
- Daniel Talmor
- Daniela Benvenuti
- Darshana Rathod
- David Blythe
- David Carpio
- David Dries
- David Perez-Torres
- David Slessor
- David Wrathall
- Davide Chiumello
- Deborah Welsh
- Deepak Jeswani
- Demetrio Carriedo
- Detajin Junhasavasdikul
- Diana Alvarez
- Dianne Hill
- Dick Nahar
- Didem Sozutek
- Diego De Mendoza
- Diego Rolando Morocho Tutillo
- Dieneke Kienhorst
- Dimitrios Matamis
- Dina Gomaa
- Dolf Weller
- Domenico Gelormini
- Don Walsh
- Doumiri Mouhssine
- Dácil Parrilla
- Edoardo Picetti
- Edoardo Piervincenzi
- Eduardo Beck
- Eduardo Labarca
- Edward Fysh
- Edward Litton
- Ege Eroglu
- Elena Nikolic
- Eleni Massa
- Eleni Mouloudi
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- Eliana Markman
- Elias Baedorf Kassis
- Elif Erdogan
- Elisa Boni
- Elisa Estenssoro
- Elisa Kam
- Elisabet Garcia
- Elisabeth Surlemont
- Elisabetta Pecci
- Elisabetta Pierucci
- Elizabeth Ramey
- Elizabeth Stevenson
- Elizabeth Wilby
- Elliot Bertram-Ralph
- Elliot Yates
- Elsa Sousa
- Eman Shebl
- Emanuele Sani
- Emilio Maseda
- Emmanuel Guerot
- Enrique Cereijo
- Enrique Paz
- Enrique Platas
- Eric Frans
- Erin Williams
- Estefania Prol-Silva
- Etienne Ghrenassia
- Ettore Vascotto
- Eugenio Garofalo
- Eugenio Luis Palazon Sanchez
- Ewan Goligher
- Ezgi Ozyilmaz
- Ezgi Özyilmaz
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- Fatma Yildirim
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- Federica Vagginelli
- Federico Gordo
- Fekri Abrough
- Felipe de Jesus Montelongo
- Felipe Martinez
- Felix Martin
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- Fernando da Silva Ramos
- Fernando Pachas Alvarado
- Fernando Rios
- Fernando Rios
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- Feza Bacakoglu
- Figen Esen
- Filiep Soetens
- Finn H Andersen
- Francesca Lucchese
- Francesca Orsenigo
- Francesco Curto
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- Francis Schneider
- Francisco J Parrilla
- Frank Chemouni
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- Frank Van Haren
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- Françoise Labat
- Frederik Seiler
- Frédérique Schortgen
- Gabriel Omar Heredia Orbegoso
- Gabriel Preda
- Gabriel Rodriguez
- Gabriel Wardi
- Gabriela Bai
- Gabriele Leonie Schwarz
- Gabriele Sales
- Gabrielle Hanlon
- Gaetano Perchiazzi
- Gaston Aguirre
- Gavin Perkins
- Gaëtan Beduneau
- Gemma Rialp
- Gennaro De Pascale
- Gerardo Aguilar
- Ghamdan Al Sadeh
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- Giacomo Berta
- Giacomo Grasselli
- Giacomo Grasselli
- Gianluca Zani
- Gianmario Monza
- Gilda Cinnella
- Giorgio Antonio Iotti
- Giovanna Soto
- Giovanni Mistraletti
- Giovanni Vitale
- Goligher Ewan C
- Gong Yu
- Gonzalo Pagella
- Govindan Balaraj
- Graciela Paz
- Graciela Zakalik
- Graeme Duke
- Grasselli Giacomo
- Greet Hermans
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- Grisma Patel
- Guglielmo Consales
- Guilherme Domingos
- Guillaume Voiriot
- Guillermo Bugedo
- Guillermo Bugedo
- Guillermo Malpartida
- Gulbin Aygencel
- Guo Xi
- Guojun Pan
- Guoxiu Zhang
- Gustavo Lugo Goytia
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- Gustavogcha Chaparro
- Gwenael Prat
- Gülseren Elay
- Haibo Qiu
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- Hanane Ezzouine
- Hans van der Hoeven
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- Harald Zetterquist
- Harish Mallapura Maheswarappa
- Harshal Bawangade
- Hector Higo Leon Yoshido
- Helbert Esquivel Gallegos
- Helena Mansson
- Helga Ceunen
- Heloisa Castro
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- Hidenobu Kamohara
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- Hiromasa Irie
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- Hongping Qu
- Hongsheng Zhao
- Hongwen Zhang
- Hongyang Xu
- Hua Luo
- Huseyin Arikan
- Iacopo Cappellini
- Ian Kerslake
- Ignacio Martin-Loeches
- Ignacio Saez
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- Irene Fernandez
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- Jialin Liu
- Jian-Feng Wu
- Jie Yan
- Jin Won Huh
- Jinwoo Lee
- Jiuzhi Zhang
- Joaquin Amador
- Jocyelle Vieira
- Johan Berkius
- Johan Berkius
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- John Trinder
- Jon Henrik Laake
- Jon Henrik Laake
- Jonathan Barrett
- Jonathan Chelly
- Jonathan Zarka
- Jonathon Truwit
- Joo Han Song
- Jorge Cabrera
- Jose Manuel Allegue
- Joshua A Englert
- José Cruz
- José Portugal
- João Carvalho
- Juan Conde
- Juan Hidalgo
- Juan Ignacio Silesky Jimenez
- Juan Luis Galeas-Lopez
- Judith Sagardia
- Julio Badie
- Julio Yáñez
- Jun Kataoka
- Juna Tirapu
- Junji Kumasawa
- Kai Chen
- Kamal Nasir
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- Karen J Bosma
- Karen Williams
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- Katsunori Mochizuki
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- Keith Hugill
- Kengo Asano
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- Kevin Clarkson
- Kevin Clarkson
- Kevin Eng
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- Kiyoyasu Kurahashi
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- Koen Simons
- Koichi Arinaga
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- Konstantin Shapovalov
- Konstanty Szuldrzynski
- Konstanty Szuldrzynski
- Kotaro Yamamoto
- Kristian Strand
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- Kyung Sook Hong
- Laake Jon Henrik
- Laffey John G
- Lakshay Bhakhtiani
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- Sebastian Fredes
- Sebastiano Macheda
- Sema Sari
- Sema Turan
- Semih Aydemir
- Seok Jeong Lee
- Serdar Efe
- Serge Heines
- Seyed Mohammadreza Hashemian
- Seyed Mohammadreza Hashemian
- Shailesh Bihari
- Sharique Ansari
- Shay McGuinness
- Shigeki Saito
- Shihan Mahmud Redwanul Huq
- Shinichiro Ohshimo
- Shinshu Katayama
- Shouhong Wang
- Shuchi Kaushik
- Shuhei Niiyama
- Silvia Avila Fuentes
- Silvia De Rosa
- Silvina Borello
- Silvio Antonio Namendys-Silva
- Simant Jha
- Simon Bocher
- Simon Chau
- Simon Whiteley
- Simone Maria Zerbi
- Sivakumar Nandakumar
- Slavenka Straus
- Sofia Nikolakopoulou
- Souheil Elatrous
- Srinivas Samavedam
- Stacy House
- Stefania Buttera
- Stefania Sovatzis
- Stefano Clementi
- Stefano Muttini
- Stephanie Hunter
- Stephanie Nonas
- Stephanie Piras
- Stéphanie Gelinotte
- Su Hwan Lee
- Subhash Acharya
- Subhash P Acharya
- Sughrat Siddiqui
- Suha Bozbay
- Sultan Alamri
- Sundar Raj Ashok
- Sunil Jamadarkhana
- Sunthiti Morakul
- Susana Temprano
- Sébastien Ena
- Sébastien Jochmans
- Sébastien Perbet
- Taha Pasha
- Tai Pham
- Tai SunPark
- Taiga Itagaki
- Takuya Shiga
- Tamaas Leiner
- Tamasato Tamasato
- Tananchai Petnak
- Tao Yu
- Tapia Muñoz
- Tarek Dendane
- Tayyba Naz Aslam
- Teobaldo Quintana
- Terje Legernaes
- Tetsuya Yumoto
- Theonymfi Papavasilopoulou
- Thomas Clark
- Thomas Piraino
- Thuy Nga Phan
- Tiago Leonor
- Tiago Pereira
- Tiehe Qin
- Tim Cook
- Tim Frenzel
- Tim Smith
- Todd Rice
- Tommaso Tonetti
- Tomohito Sadahiro
- Toshikazu Abe
- Türkay Akbas
- Ulrike Buehner
- Valeria Lascari
- Valerie Banner-Goodspeed
- van Haren Frank
- Vanesa Alejandra Pavlotsky
- Venkat Sundaram
- Vera Pereira
- Victor Hugo Madrigal Robles
- Victoria McCredie
- Vijay Kumar Agrawal
- Vijayanand Palaniswamy
- Viratch Tangsujaritvijit
- Virginia Porta
- Virginie Lemiale
- Vito Fanelli
- Vitor Mendes
- Vladimir Cerny
- Volkan Inal
- Wang Ruilan
- Wei Zhang
- Weixin Zhang
- Wensen Pan
- Willy Diaz
- Willy Porras
- Wilson Oliveira Filho
- Wojciech Serednicki
- Won-Yeon Lee
- Wu Dawei
- Wunsch Hannah
- Xandra Yanina Rodriguez Tucto
- Xavier Souloy
- Xia Hongtao
- Xiang-Dong Guan
- Xiaobo Yang
- Xie Yun
- Yalim Dikmen
- Yari Gollo
- Yaseen Arabi
- Yaseen Arabi
- Yasemin Seker Tekdos
- Yazcitk Sandoval
- You Shang
- Youjin Chang
- Young Ju Lee
- Young-Jae Cho
- Young-Jae Cho
- Yuda Sutherasan
- Yufeng Feng
- Yukako Obata
- Yupeng Qi
- Yutthana Apichatbutr
- Yvette Chou-Lie
- Zafer Çukurova
- Zhang Minwei
- Zhanhong Tang
- Zheng-Jiang Xing
- Zhenglong Ye
- Zoltan Kulcsar
- Zsolt Molnar
- Zsolt Molnar
- Zsuzsanna Szabo
- Óscar Peñuelas
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2023
- Field of study
Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society
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