Weaning From Mechanical Ventilation update

Nearly 800,000 patients require mechanical ventilation yearly. There’s no doubt it is a life-saving intervention, but it is one that is fraught with the potential for iatrogenesis, especially if continued for longer than necessary. That is the main message of this review in the NEJM by John F. McConville and John P. Kress (father of the sedation holiday) from the University of Chicago. They describe how to reduce the duration of intubation and mechanical ventilation to the absolute minimum through aggressive and evidence-based strategies to be implemented before, during, and after the tube goes in. Hence, the authors prefer the term “liberation” over “weaning” from the ventilator, encouraging readers to see mechanical ventilation as a burden that should be rapidly removed in those who no longer need it. Liberation in general terms requires that the condition that lead to mechanical ventilation be improving and that the patient has adequate respiratory muscle strength to sustain spontaneous breathing and adequate gas exchange. Link Here…