Difficult weaning from mechanical ventilation is a major problem in critically ill patients. The pathophysiology of weaning failure is complex and multiple causes for difficult weaning may exist in any single patient. We have recently developed a structural framework (‘ABCDE’) for the assessment and treatment of difficult-to-wean patients. In this article, we present the case of a difficult-to-...

The aim of this study was to determine whether gastric intramucosal pH (pHim) and/or gastric intramucosal carbon dioxide tension (PCO2,im) measured by tonometry can be used to predict the success of weaning in chronic obstructive pulmonary disease (COPD) patients. Twenty six consecutive COPD patients, undergoing mechanical ventilation for acute respiratory failure and satisfying the criteria of...

BACKGROUND Many patients with organophosphate poisoning require mechanical ventilation. Muscle acetylcholinesterase (AChE) activity determines the impairment of muscle force generation, and red blood cell (RBC) AChE has been regarded as a surrogate for muscle AChE in organophosphate poisoning. Therefore, this study was conducted to investigate whether RBC AChE at presentation can predict the du...

A 76-year-old Korean woman visited to emergency room because of respiratory arrest and admitted to intensive care unit of the hospital. Severe hypothyroidism was diagnosed after repeated failure of weaning mechanical ventilator. Respiratory arrest and weaning failures were considered to be associated with hypoventilation due to hypothyroidism. She was recovered and weaned from mechanical ventil...

BACKGROUND The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPC...