Leo M Heunks and Johannes G van der Hoeven. Critical Care 2010, 14:245doi:10.1186/cc9296. Published: 8 December 2010
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.
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