Predicting weaning failure from invasive mechanical ventilation: The promise and pitfalls of clinical prediction scores

Table 1 Summary of the various prediction scores to predict weaning failure

Scoring method	Interpretation	Uses	Limitations
1 Morganroth scale	Score of < 55 predicts successful weaning	Applied to patients requiring short-term and long-term mechanical ventilation	Limited data
2 RSBI	Score of < 105 predicts successful weaning	Easy to calculate	Can be confounded by multiple patient factors
3 CROP index	Score of > 13 mL/breath/min predicts successful weaning	Includes respiratory and ventilator parameters	Cannot be used in neuro patients
4 Gluck and Corgian score	Score of < 3 predicts successful weaning	Simple bedside measurement	Not validated in large studies
5 BWAP	Score of > 50 predicts successful weaning	Comprehensive weaning checklist	Limited data
6 Modified Burns Wean Assessment Program	Score of > 60 predicts successful weaning	Useful for long-term mechanical ventilation	Limited data
7 Persian weaning tool	Score of > 50 suggests readiness to wean	Similar to BWAP	Limited data
8 HACOR scoring	Score of > 5 predicts weaning failure	Easy bedside tool	Limited data
9 WEANS NOW	Score of 1 or more predicts weaning failure	Multiple parameters included	Complex
10 ExPreS	Score of > 59 has a high probability of extubation success	Simple tool, shown to reduce extubation failure rates	Not validated in large studies

RSBI: Rapid shallow breathing index; BWAP: Burns Wean Assessment Program.