Estimation of the optimal time needed for weaning of Intensive Care Unit tracheostomized patients on mechanical ventilation. A prospective observational study.

Estimation of the optimal time needed for weaning of Intensive Care Unit tracheostomized patients on mechanical ventilation. A prospective observational study.


  • Chrisoula Marinaki ICU NURSE
  • Theodoros Kapadochos
  • Theodoros Katsoulas
  • Ivan Rubbi
  • Athanasia Liveri
  • Areti Stavropoulou
  • Antonio Bonacaro
  • Dimitrios Papageorgiou


tracheostomy, mechanical ventilator, ventilator weaning, Intensive Care Units, nursing care


Background and aim: Determining the time that is required for weaning, as well as the factors that influence it can be used for the appropriate planning of patient's medical and nursing care. The aim of this study is to estimate the optimal time an Intensive Care Unit (ICU) patient with tracheostomy needs to wean from mechanical ventilation.

Methods: This prospective observational study was conducted on 162 patients from two general hospitals in Athens, Greece.  A specially designed recording form was created to conduct the study. The Statistical Package for the Social Sciences (SPSS) v.25 for Windows was used to record and analyze the data. The level of statistical significance was set at α=5%.

Results: Results were found after comparing and associating the demographic and clinical characteristics and medical history of patients with the duration of weaning, the length of post-tracheostomy ICU stay and the time from intubation to tracheostomy.

Conclusions: According to the results of our study, there are various factors that affect success and duration of weaning. More specifically, there seems to be an association between duration of weaning and age, number of closure attempts, success of closure, time from intubation to tracheostomy, length of the patient's post-tracheostomy ICU stay and diagnosis upon admission. The shorter the duration of weaning, the greater the benefits for the patients themselves, such us avoiding respiratory damage, reduction of mortality and morbidity and preventing of length of patient’s ICU stay.


Blackwood B, Alderdice F, Burns KE, Cardwell CR, Lavery G, O’Halloran P. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev, 2010 May 12;(5):CD006904. doi: 10.1002/14651858.CD006904.pub2.

Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA, 2002 Jan 16;287(3):345-55. doi: 10.1001/jama.287.3.345.

Thille AW, Cortes- Puch I, Esteban A. Weaning from the ventilator and extubation in ICU. Curr opin crit care, 2013;19(1):57-64. doi: 10.1097/MCC.0b013e32835c5095.

Cosentino C, Fama M, Foa C, et al. Unplanned extubations in Intensive Care Unit: evidences for risk factors. A literature review. Acta Biomed, 2017 88(Suppl 5): 55-65.

Tobin M. Principles and Practice of Mechanical Ventilation, Third Edition McGraw-Hill Companies; 2006. p. 1353- 1372.

Yazici B, Yolacan S. A comparison of various tests of normality. J Stat Comput Simul, 2007 Feb;77(2): 175- 183. doi: 10.1080/10629360600678310.

Razali NM, Wah YB. Power comparisons of Shapiro- Wilk, Kolmogorov- Smirnov, Lilliefors and Anderson- Darling tests. Journal of Statistical Modeling and Analytics, 2011 Jan;2(1): 21-33.

van der Lely AJ, Veelo DP, Dongelmans DA, Korevaar JC, Vroom MB, Schultz MJ. Time to wean after tracheotomy differs among subgroups of critically ill patients: Retrospective Analysis in a Mixed Medical/Surgical Intensive Care Unit. Respir Care, 2006 Dec;51(12):1408 –1415.

Quiñones-Ossa GA, Durango-Espinosa YA, Padilla-Zambrano H, et al. Current Status of Indications, Timing, Management, Complications, and Outcomes of Tracheostomy in Traumatic Brain Injury Patients. J Neurosci Rural Pract, 2020 Apr;11(2):222-229. doi: 10.1055/s-0040-1709971.

Miles B, Schiff B, Ganly I, et al. Tracheostomy during SARS-CoV-2 pandemic: Recommendations from the New York Head and Neck Society. Head neck, 2020 Jun;42(6):1282- 1290. doi: 10.1002/hed.26166. Epub 2020 Apr 20.

Takhar A, Walker A, Tricklebank S, et al. Recommendation of a practical guideline for safe tracheostomy during the Covid – 19 pandemic. Eur Arch Otorhinolaryngol, 2020 Aug;277(8): 2173- 2184. doi: 10.1007/s00405-020-05993-x. Epub 2020 Apr 21.

Attia AAE, Abdullatif DA, AbdElGhany SMD. Factors affecting weaning of mechanically ventilated patients. Egyptian journal of health care, 2022 Jun;13(2): 82-97. doi: 10.21608/EJHC.2022.228536.

Dermot Frengley J, Sansone GR, Shakya K, Kaner RJ. Prolonged mechanical ventilation in 540 seriously ill older adults: effects of increasing age on clinical outcomes and survival. J Am Geriatr Soc, 2014 Jan;62(1):1-9. doi: 10.1111/jgs.12597. Epub 2014 Jan 9.

Damuth E, Mitchell JA, Bartock JL, Roberts BW, Trzeciak S. Long- term survival of critically ill patients treated with prolonged mechanical ventilation: a systemic review and metanalysis. Lancet Respir Med, 2015 Jul;3(7):544-53. doi: 10.1016/S2213-2600(15)00150-2. Epub 2015 May 20.

Penuelas O, Frutos- Vivar F, Fernandez C, et al. Characteristics and outcomes of ventilated patients according to time to liberation from mechanical ventilation. Am J Respir Crit Care Med, 2011 Aug 15;184(4):430-437. doi: 10.1164/rccm.201011-1887OC.

Freeman BD. Tracheostomy update: when and how. Crit Care Clin. 2017 Apr;33(2): 311–322. doi: 10.1016/j.ccc.2016.12.007.

Klotz R, Probst P, Deininger M, et al. Percutaneous versus surgical strategy for tracheostomy: a systematic review and meta-analysis of perioperative and postoperative complications. Langenbecks Arch Surg, 2018 Mar;403(2):137-149. doi: 10.1007/s00423-017-1648-8. Epub 2017 Dec 27.

Long SM, Chern A, Feit NZ, et al. Percutaneous and open tracheostomy in patients with COVID-19: comparison and outcomes of an institutional series in New York City. Ann Surg, 2021 Mar 1;273(3):403-409. doi: 10.1097/SLA.0000000000004428.

McCredie VA, Alali AS, Scales DC, et al. Effect of early versus late tracheostomy or prolonged intubation in critically ill patients with acute brain injury: a systematic review and meta-analysis. Neurocrit Care, 2017 Feb 26(1):14–25. doi: 10.1007/s12028-016-0297-z.

McGrath BA, Brenner MJ, Warrillow SJ, et al. Tracheostomy in the COVID- 19 era: global and multidisciplinary guidance. Lancet Respir Med, 2020 Jul;8(7):717-725. doi: 10.1016/S2213-2600(20)30230-7. Epub 2020 May 15.







How to Cite

Estimation of the optimal time needed for weaning of Intensive Care Unit tracheostomized patients on mechanical ventilation. A prospective observational study. Acta Biomed [Internet]. 2023 Apr. 24 [cited 2024 Jun. 20];94(2):e2023103. Available from:

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