Overview of Weaning from Mechanical Ventilation: Methods and Causes of Weaning Difficulty

Abstract

Weaning patients from mechanical ventilation (MV) which means transition from mechanical ventilated breathing to spontaneous breathing is considered one of the critical decisions in intensive care unit. Weaning procedures are frequently initiated only when the underlying illness state that required MV has been significantly improved or resolved to the point of being capable of sustaining spontaneous breathing.  However, a percent of patients fail and are re-intubated despite fulfillment of all the current weaning criteria and this may be due to the heterogenecity of critically ill patients which impairs the predictive accuracy of the available indices in different patient subgroups. Although rapid and safe discontinuation of MV should be the objective for the majority of patients, both premature and unreasonably delayed extubation still occur, leading to adverse outcomes. Thus, weaning is challenging, represents a large part of the ventilation period and concerns all mechanically ventilated patients surviving their stay. The aim of the present study was to review the methods of Weaning from Mechanical Ventilation and to find a suitable parameter for prediction of failed weaning from mechanical ventilation to prevent hazards of prolonged intubation and ventilation and to improve outcome in these critically ill patients.