Ventilatory weaning: systematic review

Abstract

Introduction: mechanical ventilation is a life support treatment, in which using a machine that provides ventilatory and oxygen support, we facilitate gas exchange and work of breathing in patients with respiratory failure. Aim: we propose to systematically review the literature with the highest level of evidence on weaning from mechanical ventilatory support. Methods: the PRISMA method was used during the writing of this review. Results: 957 references were found, of which 909 were eliminated because they were not empirical articles, did not address the aim of the review, or did not have the full text. Finally, 48 articles were included. The evidence indicates that the use of standardized weaning protocols or guidelines helps to decrease the total duration (days) of mechanical ventilation by an average of 25 %. Conclusions: optimal management of mechanical ventilation and weaning requires a dynamic and collaborative decision to minimize complications and avoid delays in the extubation transition, so we must consider several factors, such as the initial intubation facility, the patient's medical condition, the environment within which extubation will take place, the team acting in that process.