title: Weaning from mechanical ventilation and sedation.
abstract: OBJECTIVE
  Guidelines for weaning from sedation and weaning from ventilator gained increasing interest in recent years. This includes patients with acute respiratory distress syndrome, as well as other mechanically ventilated patients. This review will give an overview of the current literature and practice guidelines in ventilator and sedation weaning.
  
  
  RESULTS
  Sedation and ventilator weaning are closely linked. Weaning protocols for both sedation and ventilator weaning should be implemented in daily routine. The essential element of such algorithm should be a daily spontaneous awakening trial and spontaneous breathing trial. Furthermore, regularly monitoring for deepness of sedation and delirium should be implemented. Too deep sedation, as well as prolonged delirium is associated with higher mortality.
  
  
  CONCLUSIONS
  The most important conclusion we come to from recent randomized controlled trials is that only using an integrative algorithm for sedation and ventilator weaning can improve survival of ICU patients.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Alawi
authors.initials: A
authors.lastname: Luetz
authors.forename: Anton
authors.initials: A
authors.lastname: Goldmann
authors.forename: Steffen
authors.initials: S
authors.lastname: Weber-Carstens
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D000465:Algorithms; D016292:Procedural Sedation; D020927:Dexmedetomidine / Q000494:pharmacology; D006801:Humans; D018908:Muscle Weakness / Q000209:etiology; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012119:Respiration; D012121:Respiration, Artificial; D014140:Tracheotomy; D015300:Ventilator Weaning
chemical_list: D020927:Dexmedetomidine