Weaning from Prolonged Mechanical Ventilation

First Things First (assess & treat for the following)

• Prolonged mechanical ventilation (PMV) is typically defined as >21 days of ventilator dependence.
• Presumes that standard efforts at ventilator liberation have been consistently applied and unsuccessful
  • Therapist-driven protocols
  • Daily assessment to determine if patient is able to resume spontaneous ventilation
  • Spontaneous breathing trial with assessment of clinical response followed by extubation
• In the absence of clearly irreversible disease, no patient should be considered permanently ventilator-dependent.