CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Vnitř. Lék., 47, 2001, No. 9, p. 613-620 |
Weaning from Mechanical Ventilation Polák F., Bělohlávek J., Hrubý M., Novák F.: IV. interní klinika Všeobecné fakultní nemocnice, Praha, přednosta doc. MUDr. Aleš Žák, CSc. |
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Summary: Weaning from mechanical ventilation is not complicated in the majority of patients, in some,
however, this process is very complicated and lengthy. These patients are described as difficult to
wean. A suitable weaning strategy and properly timed extubation or decannulation is important
not only from the aspect of the patient´s health status but also with regard to costs of care. When
selecting patients suitable for weaning it is useful to use prognostic indicators of success. The
Tobin-Yang index and ratio Pa O2 /FiO2 seem to be most useful. Based on available information it
seems that the pressure support and weaning by means of T-piece is more effective than weaning
using the SIMV regime. Promising seems the use of non-invasive ventilation but this was not
proved unequivocally so far. The use of weaning protocols reduces the weaning period from
mechanical ventilation. The authors summarize most recent findings on the weaning problem
incl. the most frequently used ventilation regimes and prognostic indicators of successful weaning.
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