Weaning from mechanical ventilation: old and new strategies.
The strategies available for weaning patients from mechanical ventilation are many: T-piece mode, SIMV, PSV, and combinations of each. T-piece trials alternating with SIMV or AC provide periods of spontaneous breathing with rest on the ventilator. Decreasing SIMV rates gradually increases the patient's independence and spontaneous breathing; however, may result in an increased work of breathing with some systems. Alternatives such as flow-by and the addition of PSV may assist in the reduction of airway resistance. PSV weaning alone or in combination with SIMV or T-piece trials reduces work of breathing, promotes respiratory muscle training, and improves patient-ventilator interaction. Schuster states "the specific weaning technique employed is often less important than the care with which it is applied."
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D002985:Clinical Protocols / Q000592:standards; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D011175:Positive-Pressure Respiration; D011659:Pulmonary Gas Exchange; D015656:Respiratory Mechanics; D015300:Ventilator Weaning / Q000379:methods / Q000451:nursing*