Weaning from Prolonged Mechanical Ventilation
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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.