title: Provision of long-term mechanical ventilation.
abstract: When patients suffer prolonged mechanical ventilation, physicians are faced with a series of decisions beginning in the intensive care unit (ICU) and extending into a broadening spectrum of post-ICU levels of care. This article reviews current thinking and outcome data on when and how to perform the tracheostomy, as well as when and where the patient should be transferred from the ICU for continued weaning efforts or support. Decannulation after success in weaning and continuation of ventilation at home are also addressed.
authors.affiliation: Barlow Respiratory Hospital, Los Angeles, California, USA. djs@barlow2000.org
authors.forename: D J
authors.initials: DJ
authors.lastname: Scheinhorn
authors.forename: M
authors.initials: M
authors.lastname: Stearn-Hassenpflug
mesh_terms: D003422:Critical Care / Q000379:methods; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D010351:Patient Discharge; D018579:Patient Selection; D010360:Patient Transfer / Q000379:methods; D011383:Progressive Patient Care / Q000379:methods; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D014139:Tracheostomy / Q000379:methods*; D015300:Ventilator Weaning / Q000379:methods