, Volume 168, Supplement 1, pp 829–832 | Cite as

Difficult weaning from mechanical ventilation

  • J. C. Chevrolet
Acute Respiratory Failure


Difficult weaning is fortunately a rare occurrence in mechanically ventilated patients in ICU. When faced with this problem, a vast number of factors must be carefully considered simultaneously: physiological adjustment, technical problems (tubing, circuit resistances, ...) [13]. The most promising approach to difficult weaning to date centers on the respiratory muscle function which represents the most common factor allowing weaning success or failure.

Key words

COPD patients Neuromuscular disease Difficult weaning Respiratory muscle function 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sporn H, Morganroth M (1988) Discontinuation of mechanical ventilation. Clin Chest Dis 9:113–126Google Scholar
  2. 2.
    Marini J (1988) Weaning from mechanical ventilation. Am Rev Respir Dis 138:1043–1046PubMedGoogle Scholar
  3. 3.
    Tobin M, Perez W, Guenther S, Semmes B, Mador M, Allen S, Lodato R, Dantzker D (1986) The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation. Am Rev Respir Dis 134:1111–1118PubMedGoogle Scholar
  4. 4.
    Kelly S, Rosa A, Field S, Coughlin M, Shizgal H, Macklem P (1984) Inspiratory muscle strength and body composition in patients receiving total parenteral nutrition therapy. Am Rev Respir Dis 130:33–37PubMedGoogle Scholar
  5. 5.
    Kaelin R, Assimacopoulos A, Chevrolet J (1987) Failure to predict 6 month survival of patients with COPD requiring mechanical ventilation by analysis of simple indices: a prospective study. Chest 92:971–978PubMedCrossRefGoogle Scholar
  6. 6.
    Truwitt J, Marini J, Lamb W (1988) The work of spontaneous brething can be predicted non invasively during mechanical ventilation. Am Rev Respir Dis 137:64AGoogle Scholar
  7. 7.
    Murciano D, Boczowksi J, Lecocquic Y, Milic-Emili J, Pariente R, Aubier M (1988) Tracheal occlusion pressure: a simple index to monitor respiratory muscle fatigue during acute respiratory failure in COPD patients. Ann Int Med 108:800–805PubMedGoogle Scholar
  8. 8.
    Tomilinson J, Miller K, Lorch D, Smith L, Reines H, Sahn S (1989) A prospective comparison of IMV and t-piece weaning from mechanical ventilation. Chest 96:348–352CrossRefGoogle Scholar
  9. 9.
    Benotti P, Bistrian B (1989) Metabolic and nutritional aspects of weaning from mechanical ventilation. Crit Care Med 17:181–185PubMedCrossRefGoogle Scholar
  10. 10.
    Lemaire F, Teboul J, Cinotti L, Giotto G, Abrouk F, Steg G, Macquin-Mavier I, Zapol W (1988) Acute left ventricular dysfunction during unsuccessful weaning from mechanical ventilation. Anesthesiology 69:171–179PubMedCrossRefGoogle Scholar
  11. 11.
    Smith T, Marini J (1988) Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction. J Appl Physiol 65:1488–1499PubMedGoogle Scholar
  12. 12.
    Marini J (1989) Should PEEP be used in airflow obstruction? Am Rev Respir Dis 140:1–3PubMedGoogle Scholar
  13. 13.
    Bersten A, Rutten A, Vedig A, Skowronski A (1989) Additional work of breathing imposed by endotracheal tubes, breathing circuits and ICU ventilators. Crit Care Med 17:671–677PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1990

Authors and Affiliations

  • J. C. Chevrolet
    • 1
  1. 1.Soins intensifs médicaux et Division de pneumologieHôpital Cantonal UniversitaireGenevaSwitzerland

Personalised recommendations