ABSTRACT Weaning from mechanical ventilation could be defined as the gradual process of transferring the respiratory work of breathing from the ventilator to the patients. The primary goal of weaning is timeliness, which implies that weaning should be started neither too late nor too early. Discontinuation of mechanical ventilation and removal of artificial airway are easily obtained in the majority of patients since about 70-80% of the patients are extubated when routine clinical criteria are fulfilled. This, however, is not always the case. In fact, about 20-30% of the patients present a difficult weaning. Patients require mechanical ventilation support when the ventilatory and/or gas exchange capabilities of their respiratory system fail. This respiratory failure can be the results of impairment between the load imposed on the respiratory system and the capacity of the respiratory muscle to perform this increased work of breathing. Shortly, the factors that limit the weaning process can be summarized as follows: 1) oxygenation, 2) respiratory load (table 1) and capacity of the respiratory muscle to accomplish this load, 3) cardiovascular performance, 4) psychological factors. To quantify these factors a great number of weaning indices has been proposed. However, none has been demonstrated to able to predict the weaning success, apart in patients with chronic obstructive pulmonary disease. Furthermore, the probability of remaining under mechanical ventilation is statistically higher in patients undergoing uncontrolled clinical practice when compared to a fixed protocol previously agreed.

Weaning from mechanical ventilation

VOLTA, Carlo Alberto;
2006

Abstract

ABSTRACT Weaning from mechanical ventilation could be defined as the gradual process of transferring the respiratory work of breathing from the ventilator to the patients. The primary goal of weaning is timeliness, which implies that weaning should be started neither too late nor too early. Discontinuation of mechanical ventilation and removal of artificial airway are easily obtained in the majority of patients since about 70-80% of the patients are extubated when routine clinical criteria are fulfilled. This, however, is not always the case. In fact, about 20-30% of the patients present a difficult weaning. Patients require mechanical ventilation support when the ventilatory and/or gas exchange capabilities of their respiratory system fail. This respiratory failure can be the results of impairment between the load imposed on the respiratory system and the capacity of the respiratory muscle to perform this increased work of breathing. Shortly, the factors that limit the weaning process can be summarized as follows: 1) oxygenation, 2) respiratory load (table 1) and capacity of the respiratory muscle to accomplish this load, 3) cardiovascular performance, 4) psychological factors. To quantify these factors a great number of weaning indices has been proposed. However, none has been demonstrated to able to predict the weaning success, apart in patients with chronic obstructive pulmonary disease. Furthermore, the probability of remaining under mechanical ventilation is statistically higher in patients undergoing uncontrolled clinical practice when compared to a fixed protocol previously agreed.
2006
Volta, Carlo Alberto; Alvisi, V; Marangoni, E.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/471660
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 1
  • ???jsp.display-item.citation.isi??? ND
social impact