title: Clinical review: the ABC of weaning failure--a structured approach.
abstract: About 20% to 30% of patients are difficult to wean from invasive mechanical ventilation. The pathophysiology of difficult weaning is complex. Accordingly, determining the reason for difficult weaning and subsequently developing a treatment strategy require a dedicated clinician with in-depth knowledge of the pathophysiology of weaning failure. This review presents a structural framework ('ABCDE') for the assessment and treatment of difficult-to-wean patients. Earlier recognition of the underlying causes may expedite weaning from mechanical ventilation.
authors.affiliation: Department of Intensive Care Medicine (632), Radboud University Nijmegen Medical Centre, Postbox 9101, 6500 HB Nijmegen, The Netherlands. L.Heunks@ic.umcn.nl
authors.forename: Leo M
authors.initials: LM
authors.lastname: Heunks
authors.forename: Johannes G
authors.initials: JG
authors.lastname: van der Hoeven
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008659:Metabolic Diseases / Q000209:etiology / Q000503:physiopathology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy; D015300:Ventilator Weaning / Q000009:adverse effects / Q000379:methods*