Psychological Dependence on Mechanical Ventilation Resolved by "Sigh-Breath" Intermittent Mandatory Ventilation

Psychological dependence on mechanical ventilation, and the resultant fear of being weaned from the ventilator, can be especially severe in patients with chronic obstructive pulmonary disease; this is probably because such patients are all too familiar with the terrors of dyspnea and because they often know their disease is permanent and life-shortening. We have resolved this fear of weaning in some patients by employing a variant of intermittent mandatory ventilation that employs two hyperinflating mechanical sighs every four minutes.