Discontinuation of mechanical ventilation

Most patients who undergo mechanical ventilation are able to discontinue ventilatory support quickly and easily by any of a variety of techniques. A small proportion of patients require prolonged mechanical ventilation. These patients must be weaned from the ventilator by a process in which the level of mechanical ventilatory support is progressively decreased. A systematic and comprehensive approach to correcting or optimizing the factors that may adversely affect the weaning process is important. When to begin weaning in the long-term ventilator patient, mechanisms of weaning failure, and the strategy and techniques of weaning are all discussed.