title: Weaning from mechanical ventilation: where were we then, and where are we now?
abstract: Weaning patients from long-term mechanical ventilation (LTMV) has been an important focus of clinical process improvement initiatives and research for decades. The purpose of this article is to describe the science that drives our current weaning practices, including (1) preweaning assessment, (2) individualized weaning plans, (3) weaning prediction, (4) the use of protocols and guidelines for weaning trials and sedation management, (5) timing of tracheostomy placement, and (6) system initiatives for the management of LTMV patients. Finally, this article discusses potential interventions for improving the outcomes of patients who require prolonged mechanical ventilation.
authors.affiliation: University of Virginia Health System, School of Nursing, University of Virginia, Box 800826, Claude Moore Building, 225 Jeanette Lancaster Way, Charlottesville, VA 22903-3387, USA. smb4h@virginia.edu
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Burns
mesh_terms: D057189:Checklist; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D009730:Nursing Assessment; D017410:Practice Guidelines as Topic; D013997:Time Factors; D014139:Tracheostomy / Q000451:nursing; D015300:Ventilator Weaning / Q000379:methods* / Q000451:nursing
chemical_list: D006993:Hypnotics and Sedatives