The study of patients being weaned from mechanical ventilation has offered new insights into the physiology of respiratory failure. Assessment of the balance between respiratory muscle strength, work and central drive is essential if difficulty in weaning occurs, and optimisation of these elements may improve the success of weaning. Psychological support of patients and the creation of units sp...

OBJECTIVE The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronar...

Luciele Medianeira Schifelbain, Silvia Regina Rios Vieira, Janete Salles Brauner, Deise Mota Pacheco, Alexandre Antonio Naujorks I Intensive Care Unit, Hospital de Caridade Dr. Astrogildo de Azevedo, Santa Maria, RS, Brazil. II Intensive Care Unit, Hospital de Clı́nicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. III Intensive Care Unit, HCPA, Porto Alegre, RS, Brazil; Hospital Nossa Senho...

BACKGROUND AND OBJECTIVE There is not an ideal predictor of weaning from mechanical ventilation (MV). In a large meta-analysis, despite methodological limitations, respiratory rate (RR) was considered a promising predictor. The aim of this study was to evaluate RR as a predictor of weaning failure from MV. METHODS We prospectively evaluated 166 patients scheduled for weaning from MV. RR and o...

OXYGEN consumption (V̇O2) of respiratory muscles during mechanical ventilation is usually computed as the difference between V̇O2 during controlled ventilation and V̇O2 during spontaneous ventilation. This method, though, is unpractical and sometimes even impossible. In a study published in this issue of ANESTHESIOLOGY, Bellani et al. used another interesting approach to evaluate the value of V̇O2 ...

We describe difficult weaning after prolonged mechanical ventilation in three tracheostomized children affected by respiratory virus infection. Although the spontaneous breathing trials were successful, the patients failed all extubations. Therefore a tracheostomy was performed and the weaning plan was begun. The strategy for weaning was the decrease of ventilation support combining pressure co...

BACKGROUND Approximately ten percent of patients placed on mechanical ventilation during acute illness will require long-term ventilator support. Unfortunately, despite rehabilitation, some will never be liberated from the ventilator. A method of predicting weaning outcomes for these patients could help conserve resources and minimize frustrating failed weaning attempts for this population. The...

OBJECTIVE To report the use of a second-generation antipsychotic agent to assist weaning from prolonged mechanical ventilation in an anxious patient. DESIGN Case report. SETTING Medical intensive care unit at the Hospital of the University of Pennsylvania. PATIENT A 39-yr-old white female whose severe anxiety prohibited weaning from prolonged mechanical ventilation. INTERVENTIONS Initia...

Introduction Most patients undergoing mechanical ventilation (MV) in critical care units are liberated from the ventilator within a median of 7 days. Unfortunately, some patients experience difficulty in liberation from MV during their ICU stays and require extended time on MV. It has been estimated that 40% of the patient’s duration on the ventilator is spent weaning.[1] Moreover, although pat...