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Approach to patients with long-term weaning failure
D J Scheinhorn1, D C Chao, M Stearn-Hassenpflug
1Barlow Respiratory Research Center and Barlow Respiratory Hospital, Los Angeles, CA 90026, USA.
Respiratory Care Clinics of North America
|July 19, 2000
Summary
Many intensive care unit patients require prolonged mechanical ventilation (PMV) due to incomplete recovery. This review examines outcomes for over 2700 patients treated in specialized weaning facilities.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Healthcare Management
Background:
- Up to 20% of intensive care unit (ICU) patients fail to wean from mechanical ventilation, leading to prolonged mechanical ventilation (PMV).
- Incomplete resolution of underlying conditions and economic pressures contribute to extended ICU stays.
- Post-ICU disposition decisions are complex, balancing patient condition, facility resources, and continued weaning efforts.
Purpose of the Study:
- To review outcomes of patients with PMV treated in post-ICU weaning settings.
- To analyze data from over a decade of weaning beyond the ICU.
- To describe assessment, treatment, weaning strategies, and complications in PMV patients.
Main Methods:
- Review of data spanning ten years.
- Inclusion of outcomes for over 2700 patients with PMV.
- Analysis of patients treated in long-term acute care facilities and other post-ICU weaning venues.
Main Results:
- Data from over 2700 patients with PMV were analyzed.
- Outcomes of weaning attempts in specialized post-ICU facilities were examined.
- Assessment, treatment, weaning strategies, and complications were described for PMV patients.
Conclusions:
- Specialized post-ICU facilities provide continued weaning opportunities for patients with PMV.
- Effective management of PMV requires comprehensive assessment, tailored strategies, and vigilant complication monitoring.
- Further research into optimizing weaning protocols in diverse post-ICU settings is warranted.