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Dealing with Difficult to Wean Patients

Discussion regarding weaning from mechanical ventilation. Suggested strategies for failure to wean. Up to 20% of patients requiring mechanical ventilation will suffer from difficult weaning the need of more than 7 days of weaning after the first spontaneous breathing trial, which may depend on several reversible causes: respiratory and/or cardiac load, neuromuscular and neuropsychological factors, and metabolic and endocrine disorders. Clinical consequences and/or often causes of prolonged mechanical ventilation comprise features such as myopathy, neuropathy, and body composition alterations and depression, which increase the costs, morbidity and mortality of this.

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