The Science behind Weaning from Mechanical Ventilation

Overview

Abstract
Weaning from mechanical ventilation is defi ned as the transition from the ventilatory dependence of the patient to a spontaneous breathing status. Recognizing when a patient is ready to be weaned from mechanical ventilation is greatly infl uences the outcome, and may prevent compromising a patient.
Weaning indices were developed to help the physician predict the outcome of weaning trials, a common concern in the intensive care unit (ICU) setting. Many physiological mechanisms explain the reason why many patients fail weaning trial, mostly related to a noncompliant respiratory function and cardiovascular instability. The primary goal is to reduce failed attempts, and to adopt successful weaning protocols, in order to overcome problems that may arise in the critically ill patients. The ratio of respiratory rate to tidal volume (f/Vt), among other indices, and weaning trials like pressure support ventilation (PSV) or spontaneous breathing with the use of T tube are explained.

Carlos Martinez Rodriguez, Joseph Varon

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February 2025, Volume 28 Number 1

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