Weaning from the ventilator

Abstract

Patients with COPD account for 13% of all patients receiving mechanical ventilation; COPD is the most common indication for mechanical ventilation in North America (1). Although often life saving, mechanical ventilation is associated with several major complications. Accordingly, it is important to discontinue mechanical ventilation and extubate the patient at the earliest possible time. While it is possible to wean the majority of patients from mechanical ventilation without much dif?culty,25 to 30% of patients repeatedly fail weaning trials (2, 3). These dif?cult-to-wean patients account for a considerable proportion of the workload in an intensive care unit (ICU) (1). In a survey of ventilator-supported patients, over 40% of total ventilator time was consumed by weaning the patient from the ventilator (4) and, in patients with COPD, weaning constituted 59% of the total ventilator time.