title: Weaning from mechanical ventilation.
abstract: OBJECTIVE
  Liberation from mechanical ventilation is a defining moment for intubated patients, and thus a critical clinical decision. Extubating the patient too early exposes the patient to extubation failure and reintubation. Waiting too long increases the complications of prolonged intubation. Tools to help the physician with this critical decision and to test readiness have been available for decades, and are continuously being improved. New methods to improve extubation outcomes are also being developed. This review covers the latest studies in order to help physicians take advantage of the latest developments in a rapidly evolving field.
  
  
  RESULTS
  This review highlights the recent advances in assessing and testing for readiness of weaning and liberation from mechanical ventilation, the cause of weaning failure, the value of weaning protocols, and the role of noninvasive positive pressure ventilation in liberating patients from invasive mechanical ventilation.
  
  
  CONCLUSIONS
  Recent findings are shedding more light on this topic, and transforming 'the artistic' aspect of weaning and liberation from mechanical ventilation into a more 'scientific' approach that will expedite liberation from mechanical ventilation yet without encountering high failure rates, and without exposing patients to unnecessary risks.
authors.affiliation: Division of Pulmonary & Critical Care, Department of Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Imad
authors.initials: I
authors.lastname: BouAkl
authors.forename: Pierre
authors.initials: P
authors.lastname: Bou-Khalil
authors.forename: Ghassan
authors.initials: G
authors.lastname: Kanazi
authors.forename: Chakib
authors.initials: C
authors.lastname: Ayoub
authors.forename: Mohamad
authors.initials: M
authors.lastname: El-Khatib
mesh_terms: D060666:Airway Extubation; D016292:Procedural Sedation; D020927:Dexmedetomidine / Q000494:pharmacology; D006801:Humans; D018908:Muscle Weakness / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D014139:Tracheostomy; D015300:Ventilator Weaning / Q000379:methods*
chemical_list: D020927:Dexmedetomidine