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Prolonged Mechanical Ventilation

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Evidence-Based Critical Care

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Abstract

Prolonged mechanical ventilation (PMV) is defined as mechanical ventilation for longer than 14–21 days for acute illness or injury. Use of the ProVent14 score to assess expected survival can guide provider communication with patients and caregivers. Placement of a tracheostomy can aid recovery and liberation from mechanical ventilation, but it usually should not be pursued before day 10 of mechanical ventilation. Effective weaning for PMV patients should consist of daily trials on tracheostomy collar until the patient is successfully liberated. Early mobility and use of speaking valves while still requiring ventilator support improves functional outcomes and communication with patients. Transfer to long-term acute care hospitals (LTACs) has the potential to reduce the overall cost of the episode of care by reducing readmissions to acute care hospitals. Coordination of outpatient care in post-ICU clinics could improve evaluation of post-intensive care syndrome.

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Authors and Affiliations

  1. University of North Carolina Chapel Hill, Chapel Hill, NC, USA

    Thomas Bice

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  1. Thomas Bice
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Correspondence to Thomas Bice .

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Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Bice, T. (2020). Prolonged Mechanical Ventilation. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_28

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26709-4

  • Online ISBN: 978-3-030-26710-0

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