Weaning From Mechanical Ventilation

PATIENTS who require mechanical ventilation will either be promptly weaned from the ventilator and the endotracheal tube or require more prolonged ventilatory assistance by means of a tracheostomy. Those who recover ventilatory capacity and effective pulmonary oxygen transport rapidly are better able to participate in procedures designed to promote their recovery and rehabilitation and therefore have the best prognosis. In these patients, the potential hazards of prolonged endotracheal intubation are usually avoided by early weaning.1Thus, it is imperative that the respiratory care physician constantly evaluate the need for continued ventilatory support and discontinue it and remove the artificial airway as soon as feasible. The time to consider weaning a patient from the ventilator is immediately after the respiratory emergency has been stabilized. Therefore, the original indications for ventilatory assistance, the overall clinical condition, and the physiologic resources of the patient must be continuously evaluated. PROPOSED CRITERIA FOR WEANING