Weaning patients from the ventilator.

After the underlying cause of respiratory failure in critically ill patients has been addressed, the priority is to minimize the duration of mechanical ventilation. This review outlines strategies and interventions to reduce this duration.

[1]  G. Harlow,et al.  A Protocol of No Sedation for Critically Ill Patients Receiving Mechanical Ventilation: A Randomised Trial , 2011 .

[2]  Shengwang Liu,et al.  RESEARCH Open Access , 1996 .

[3]  S. Bagshaw,et al.  Noninvasive ventilation in acute cardiogenic pulmonary edema. , 2008, The New England journal of medicine.

[4]  Shannon S Carson,et al.  The Changing Epidemiology of Mechanical Ventilation: A Population-Based Study , 2006, Journal of intensive care medicine.

[5]  A. Anzueto,et al.  Noninvasive positive-pressure ventilation for respiratory failure after extubation. , 2004, The New England journal of medicine.

[6]  R. Fernandez,et al.  Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. , 2005, JAMA.

[7]  L. Rose,et al.  A randomised, controlled trial of conventional versus automated weaning from mechanical ventilation using SmartCare™/PS , 2008, Intensive Care Medicine.

[8]  A. Pavie,et al.  Early Percutaneous Tracheotomy Versus Prolonged Intubation of Mechanically Ventilated Patients After Cardiac Surgery , 2011, Annals of Internal Medicine.

[9]  S. Epstein,et al.  Independent effects of etiology of failure and time to reintubation on outcome for patients failing extubation. , 1998, American journal of respiratory and critical care medicine.

[10]  Gordon R. Bernard,et al.  Comparison of two fluid-management strategies in acute lung injury. , 2009 .

[11]  C. Rand,et al.  A prospective, controlled trial of a protocol-based strategy to discontinue mechanical ventilation. , 2004, American journal of respiratory and critical care medicine.

[12]  Salvador Benito,et al.  Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. , 2002, JAMA.

[13]  S. Keenan,et al.  Noninvasive positive-pressure ventilation for postextubation respiratory distress: a randomized controlled trial. , 2002, JAMA.

[14]  K. Burns,et al.  Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. , 2010, The Cochrane database of systematic reviews.

[15]  D. Schoenfeld,et al.  Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. , 2000, The New England journal of medicine.

[16]  J. Wedzicha,et al.  Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. , 2004, The Cochrane database of systematic reviews.

[17]  J. Mancebo,et al.  Weaning from mechanical ventilation. , 1996, The European respiratory journal.

[18]  J. Kress,et al.  Early Tracheotomy After Cardiac Surgery: Not Ready for Prime Time , 2011, Annals of Internal Medicine.

[19]  Y. Amoateng-Adjepong,et al.  Neurologic status, cough, secretions and extubation outcomes , 2004, Intensive Care Medicine.

[20]  L. Cinotti,et al.  Acute Left Ventricular Dysfunction during Unsuccessful Weaning from Mechanical Ventilation , 1988, Anesthesiology.

[21]  Salvador Benito,et al.  Clinical Investigations in Critical CareModes of Mechanical Ventilation and Weaning: A National Survey of Spanish Hospitals , 1994 .

[22]  O. Burghuber,et al.  Incidence and outcome of weaning from mechanical ventilation according to new categories , 2009, European Respiratory Journal.

[23]  Randall Wetzel,et al.  Effect of mechanical ventilator weaning protocols on respiratory outcomes in infants and children: a randomized controlled trial. , 2002, JAMA.

[24]  A. Anzueto,et al.  Risk factors for extubation failure in patients following a successful spontaneous breathing trial. , 2006, Chest.

[25]  L. Brochard,et al.  Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. , 1994, American journal of respiratory and critical care medicine.

[26]  Peter J Pronovost,et al.  Projected incidence of mechanical ventilation in Ontario to 2026: Preparing for the aging baby boomers* , 2005, Critical care medicine.

[27]  S. Dzik.  Early goal-directed therapy in the treatment of severe sepsis and septic shock , 2002 .

[28]  M J Tobin,et al.  Pathophysiologic basis of acute respiratory distress in patients who fail a trial of weaning from mechanical ventilation. , 1997, American journal of respiratory and critical care medicine.

[29]  R. Balk.  Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial , 2010 .

[30]  W. Knaus,et al.  Predicting the duration of mechanical ventilation. The importance of disease and patient characteristics. , 1996, Chest.

[31]  L. Blanch,et al.  Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. , 1999, American journal of respiratory and critical care medicine.

[32]  S. Tatter,et al.  Predictors of successful extubation in neurosurgical patients. , 2001, American journal of respiratory and critical care medicine.

[33]  A. Esteban,et al.  A COMPARISON OF FOUR METHODS OF WEANING PATIENTS FROM MECHANICAL VENTILATION , 1995 .

[34]  S. Epstein.  Noninvasive ventilation to shorten the duration of mechanical ventilation. , 2009, Respiratory care.

[35]  W M Coplin,et al.  Implications of extubation delay in brain-injured patients meeting standard weaning criteria. , 2000, American journal of respiratory and critical care medicine.

[36]  J B Wong,et al.  Effect of failed extubation on the outcome of mechanical ventilation. , 1997, Chest.

[37]  D Hess,et al.  Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. , 2001, Chest.

[38]  iorgio,et al.  NONINVASIVE VENTILATION FOR ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE , 2000 .

[39]  Shannon S Carson,et al.  Increase in tracheostomy for prolonged mechanical ventilation in North Carolina, 1993–2002 , 2004, Critical care medicine.

[40]  J. Kress,et al.  Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. , 2000, The New England journal of medicine.

[41]  J. Steingrub.  Evolution of mechanical ventilation in response to clinical research , 2008 .

[42]  Gordon R Bernard,et al.  Comparison of two fluid-management strategies in acute lung injury. , 2006, The New England journal of medicine.

[43]  C. Gregoretti,et al.  Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients* , 2005, Critical care medicine.

[44]  G. Bernard,et al.  Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial , 2008, The Lancet.

[45]  P. Hazard,et al.  A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients* , 2004, Critical care medicine.

[46]  H. Saconato,et al.  Early versus late tracheostomy for critically ill patients. , 2012, The Cochrane database of systematic reviews.

[47]  H. Wunsch,et al.  The epidemiology of mechanical ventilation use in the United States* , 2010, Critical care medicine.

[48]  I. L. Cohen,et al.  Clinical and economic outcome of patients undergoing tracheostomy for prolonged mechanical ventilation in New York state during 1993: analysis of 6,353 cases under diagnosis-related group 483. , 1997, Critical care medicine.

[49]  F. Gordo,et al.  Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation. The Spanish Lung Failure Collaborative Group. , 1997, American journal of respiratory and critical care medicine.

[50]  J. Nicolás,et al.  Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. , 2006, American journal of respiratory and critical care medicine.

[51]  M. Tobin,et al.  A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. , 1992, The New England journal of medicine.

[52]  K. Hillman,et al.  Subglottic secretion drainage for preventing ventilator associated pneumonia: a meta-analysis. , 2013, Australian critical care : official journal of the Confederation of Australian Critical Care Nurses.