Ventilatory Methods used to Wean Patients from Mechanical Ventilation

  • J. Mancebo
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1995)

Abstract

Intubation and mechanical ventilation are routine and live-saving procedures performed in the intensive care units (ICU). However, selecting what is the most appropriate time for extubation, probably is one of the most difficult decisions physicians must make. In our experience, around 70–75% of the patients who have been intubated, usually can be extubated without major clinical problems after a brief period of clinical observation during which the patient breathes spontaneously through a T-piece with supplemental oxygen as required [1]. The rate of extubation failures, i.e. the percentage of patients who must be re-intubated, is around 10%. There are, however, important differences depending on the patients’ disease process. In fact, patients who have a chronic obstructive pulmonary disease (COPD) and who meet usual extubation criteria (adequate clinical tolerance during unsupported breathing through a T-piece during 60–120 min), rarely require re-intubation. On the contrary, patients who needed intubation and mechanical ventilation due to a neurologic disease have a high rate of extubation failures (about 30%) despite meeting usual extubation criteria; one of the reasons is probably due to the fact that these patients do not have adequate expulsive forces for the clearance of secretions.

Keywords

Fatigue Tate Cough Banner 

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© Springer-Verlag Berlin Heidelberg 1995

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  • J. Mancebo

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