High Calorie Intake Predicts Successful Weaning in Patients With Prolonged Mechanical Ventilation at a Respiratory Care Center: A Single-center Retrospective Analysis

Background/Objectives: Successfully weaning patients with prolonged mechanical ventilation (PMV: ≥21 days) from ventilators is a challenging process, and proper nutritional support is a crucial factor in this process. Previous studies have highlighted the significance of higher albumin levels and increased daily protein intake in predicting successful weaning among PMV patients. However, the importance of calorie intake in patients with PMV has remained unclear. Methods: This retrospective study included 1,038 adult patients (age >18 years) who underwent endotracheal intubation or tracheostomy and required mechanical ventilation for >21 days. Baseline characteristics, nutritional variables, disease severity, management factors and patient outcomes (hospital stay and duration of ventilator use) were analyzed between the weaning-failure and weaning-success sub-cohorts and factors associated with successful weaning were identified. Results: The participants had mean APACHE II score of 18 and a Day 1 SOFA score of 4.9 and the successful weaning rate was 70%. Multivariate logistic regression analysis revealed that higher albumin and hemoglobin levels, the absence of shock, less positive fluid status, and higher calorie intake were associated with a higher successful weaning rate; an average calorie intake higher than 25 kcal/kg/day during respiratory care center (RCC) stay predicted better successful ventilator weaning. Conclusions: Higher daily calorie intake in the RCC is associated with more successful ventilator weaning, and an average intake exceeding 25 kcal/kg/day is recommended for optimizing the weaning process.