Weaning patients off invasive ventilation

doi:10.1136/bmj.b728

Published 21 May 2009, doi:10.1136/bmj.b728
Cite this as: BMJ 2009;338:b728

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Weaning patients off invasive ventilation

Non-invasive ventilation may improve outcomes in selected patients,but the evidence is weak

The first 150 words of the full text of this article appear below.

At any given time, 30-70% of patients in the intensive careunit (ICU) are receiving mechanical ventilatory support; 70-80%of them are rapidly weaned off this support, often within afew days.¹ Weaning is more problematic in the remaining 20-30%of patients, usually because of unfavourable respiratory mechanics,residual disease processes, cardiac dysfunction, respiratorymuscle weakness, high secretion volumes, or altered mental status.The process of weaning from ventilation may account for morethan half the total time spent on the ventilator, and it consumesa considerable number of ICU resources.

Failure of weaning increases the length of stay in the ICU andhospital and exposure to the risks of prolonged ventilation,including ventilator associated pneumonia, respiratory muscledeconditioning, and airway problems such as stenosis.² ³ Inthe linked systematic review and meta-analysis (doi:10.1136/bmj.b1574),Burns and colleagues ask an important question about how tomanage patients who fail initial . . . [Full text of this article]

Andrew Ferguson, assistant professor of medicine (critical care) and anaesthesia

¹ Dalhousie University, Bethune Room 377, Halifax, NS, Canada, B3H 2Y9

andrew.ferguson@dal.ca

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Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review: Karen E A Burns, Neill K J Adhikari, Sean P Keenan, and Maureen Meade
BMJ 2009 338: b1574. [Abstract] [Full Text] [PDF]