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Weaning with or without PEEP?

Introduction: In patients with difficult weaning the role of PEEP is not fully understood. Thus different weaning protocols with and without PEEP were applied. The aim of the study was to examine the influence of PEEP on the weaning course. Methods: In 2014, the clinical progress of 26 weaning patients was analyzed with regard to the duration of weaning with and without PEEP, the weaning success and mortality based on the overall collective of patients. Result: Of these 26 patients, 12 patients received invasive ventilation (via a tracheal cannula) with PEEP and 14 without PEEP. No significant differences were found for duration of weaning for the patients with PEEP (2.2 months) and without PEEP (1.9 months) and for the weaning outcome which was successful for 7 patients with PEEP and 8 patients without PEEP. A conspicuous feature was a 27% mortality of the patients with PEEP in relation to the overall collective in comparison to 7.7% for the patients without PEEP. Furthermore, a higher comorbidity of the ventilated patients with PEEP is revealed. The comorbidities werde decompensation and cardiac arrhythmia on the left side of the heart, severe pulmonary hypertension, bronchiectases with 3 and 4 MRGN as well as a condition following apoplexy. Discusssion: In comparison of the weaning concepts with and without PEEP, no significant differences were found for the duration of weaning and weaning success. Due to the comorbidities, mortality in the group of patients with PEEP was higher than in the group without PEEP.