Airway and ventilation management

Abstract

Patients requiring intubation and mechanical ventilation due to underlying neurological disease usually have a need for prolonged weaning. Such patients include those with central disturbances of respiratory regulation (e.g. brainstem lesions), swallowing (neurogenic dysphagia), neuromuscular problems (e.g. critical illness neuro/myopathy, Guillain-Barré syndrome, paraplegia, myasthenia gravis), and/or cognitive disorders (e.g. disorders of consciousness and vigilance, severe communication disorders). Neurological, neurosurgical, intensive care, and neurorehabilitation competencies need to be bundled together to incorporate their specific requirements. Important aspects regarding weaning strategies, involving both invasive and non-invasive ventilation, are described.