{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:04:33Z","timestamp":1784588673599,"version":"3.55.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Entw\u00f6hnung von der invasiven Beatmung (Weaning) ist ein kritischer \u00dcbergangsprozess in der Intensivmedizin und nimmt bei erfolgreich extubierten Patient*innen einen erheblichen Anteil der Gesamtbeatmungsdauer ein. Eine fehlerhafte Einsch\u00e4tzung kann sowohl zu prolongierter Beatmung mit Komplikationen als auch zu verfr\u00fchten Extubationsversuchen mit erh\u00f6htem Risiko f\u00fcr Reintubationen f\u00fchren. Zur systematischen Beschreibung des Weanings wurden unterschiedliche Klassifikationsmodelle entwickelt. Die etablierte International Consensus Conference (ICC)-Weaning Klassifikation (\u201eBudapester Klassifikation\u201c) unterteilte Weaning-Verl\u00e4ufe in 3 Kategorien (einfach, schwierig und prolongiert), weist jedoch erhebliche Limitationen auf, insbesondere eine eingeschr\u00e4nkte Anwendbarkeit, fehlende Prognosekraft und ein zu kurzes Beobachtungsintervall. Mit der 2017 publizierten Weaning according to a new definition (WIND)-Klassifikation liegt erstmals ein rein zeitbasiertes, international anschlussf\u00e4higes System vor, das nahezu alle Beatmungsverl\u00e4ufe erfasst und eine konsistente Assoziation mit patientenrelevanten Outcomes zeigt. Die Validierung in gro\u00dfen internationalen Kohorten best\u00e4tigt eine deutlich verbesserte Klassifikationsrate und prognostische Trennsch\u00e4rfe im Vergleich zur ICC-Systematik. F\u00fcr den deutschsprachigen Raum bleibt jedoch insbesondere im Bereich des prolongierten Weanings eine differenzierte Untergliederung klinisch bedeutsam. Die S2k-Leitlinie \u201eProlongiertes Weaning\u201c ber\u00fccksichtigt diese Heterogenit\u00e4t in Form von insgesamt 6 Subgruppen, die f\u00fcr Prognose, Versorgungsplanung und Nachsorge essenziell sind. Die 2025 revidierte S3-Leitlinie \u201eInvasive Beatmung und Einsatz extrakorporaler Verfahren bei akuter respiratorischer Insuffizienz\u201c empfiehlt daher ein hybrides Modell, das die internationale Standardisierung durch die WIND-Klassifikation mit der differenzierten Subklassifikation des prolongierten Weanings nach der deutschen S2k-Leitlinie verbindet. Dieses Vorgehen erm\u00f6glicht sowohl internationale Vergleichbarkeit als auch die f\u00fcr die klinische Praxis im deutschsprachigen Raum notwendige Detailtiefe und stellt somit einen pragmatischen Konsens dar.<\/jats:p>","DOI":"10.1055\/a-2765-9005","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:42:52Z","timestamp":1770075772000},"page":"514-521","source":"Crossref","is-referenced-by-count":0,"title":["Weaning-Klassifikationen \u2013 WIND, ICC und prolongiertes Weaning \u2013 aus der Sicht der aktualisierten S3-Leitlinie zur invasiven Beatmung"],"prefix":"10.1055","volume":"80","author":[{"given":"Friedrich Anton","family":"Hohmann","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik Leipzig, Deutschland","place":["Leipzig"],"department":["Klinik und Poliklinik f\u00fcr An\u00e4sthesiologie und Intensivtherapie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onnen","family":"Moerer","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin G\u00f6ttingen, Deutschland","place":["G\u00f6ttingen"],"department":["Klinik f\u00fcr An\u00e4sthesiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Sch\u00f6nhofer","sequence":"additional","affiliation":[{"name":"Medizinische Hochschule Hannover, Deutschland","place":["Hannover"],"department":["Klinik f\u00fcr Pneumologie und Infektiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"f\u00fcr die Leitliniengruppe der S3-Leitlinie \u201eInvasive Beatmung und Einsatz extrakorporaler Verfahren bei akuter respiratorischer Insuffizienz\u201c:","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/S2213-2600(22)00449-0","article-title":"Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study","volume":"11","author":"T Pham","year":"2023","journal-title":"Lancet Respir Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"R322","DOI":"10.1186\/cc2913","article-title":"The outcome of extubation failure in a community hospital intensive care unit: a cohort study","volume":"8","author":"CW Seymour","year":"2004","journal-title":"Crit Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1912","DOI":"10.1164\/ajrccm.161.6.9908068","article-title":"Effect of unplanned extubation on outcome of mechanical ventilation","volume":"161","author":"SK Epstein","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1378\/chest.112.1.186","article-title":"Effect of failed extubation on the outcome of mechanical ventilation","volume":"112","author":"SK Epstein","year":"1997","journal-title":"Chest"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1164\/ajrccm.152.1.7599812","article-title":"Re-intubation increases the risk of nosocomial pneumonia in patients needing mechanical ventilation","volume":"152","author":"A Torres","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"ref6","first-page":"31","article-title":"Entw\u00f6hnung von der Beatmung unter besonderer Ber\u00fccksichtigung des prolongierten Weaning","volume":"4","author":"B Sch\u00f6nhofer","year":"2012","journal-title":"DIVI"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1183\/09031936.00010206","article-title":"Weaning from mechanical ventilation","volume":"29","author":"JM Boles","year":"2007","journal-title":"Eur Respir J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1055\/a-1010-8764","article-title":"Prolonged Weaning \u2013 S2k-Guideline Published by the German Respiratory\n          Society","volume":"73","author":"B Sch\u00f6nhofer","year":"2019","journal-title":"Pneumologie"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1164\/rccm.201602-0320OC","article-title":"Epidemiology of Weaning Outcome according to a New Definition. 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