Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Discontinuing mechanical ventilatory support.

Publication ,  Journal Article
MacIntyre, N
Published in: Chest
September 2007

The ventilator discontinuation process is a critical component of ICU care. Ongoing ventilator dependency is caused by both disease factors (eg, respiratory, cardiac, metabolic, and neuromuscular) and clinician management factors (eg, failing to recognize discontinuation potential and inappropriate ventilator settings/management). A multispecialty evidence-based task force has recommended a series of guidelines that begins with a daily ventilator weaning screen focusing on disease stability/recovery, gas exchange, hemodynamics, and respiratory drive that should be done on every patient receiving mechanical ventilatory support. In those passing this screen, a spontaneous breathing trial (SBT) should be performed. The decision to remove the artificial airway in those patients successfully passing an SBT requires further assessment of the patient's ability to protect the airway. Managing the patient who fails the SBT is one of the biggest challenges facing ICU clinicians. In general, stable, comfortable modes of assisted/supported ventilatory support should be provided between the daily weaning screen/SBT. New evidence suggests that early tracheostomy placement may facilitate the ventilator withdrawal process in those patients requiring prolonged ventilatory support.

Duke Scholars

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

September 2007

Volume

132

Issue

3

Start / End Page

1049 / 1056

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • Tracheotomy
  • Time Factors
  • Respiratory System
  • Practice Guidelines as Topic
  • Humans
  • Decision Trees
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
MacIntyre, N. (2007). Discontinuing mechanical ventilatory support. Chest, 132(3), 1049–1056. https://doi.org/10.1378/chest.06-2862
MacIntyre, Neil. “Discontinuing mechanical ventilatory support.Chest 132, no. 3 (September 2007): 1049–56. https://doi.org/10.1378/chest.06-2862.
MacIntyre N. Discontinuing mechanical ventilatory support. Chest. 2007 Sep;132(3):1049–56.
MacIntyre, Neil. “Discontinuing mechanical ventilatory support.Chest, vol. 132, no. 3, Sept. 2007, pp. 1049–56. Pubmed, doi:10.1378/chest.06-2862.
MacIntyre N. Discontinuing mechanical ventilatory support. Chest. 2007 Sep;132(3):1049–1056.
Journal cover image

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

September 2007

Volume

132

Issue

3

Start / End Page

1049 / 1056

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • Tracheotomy
  • Time Factors
  • Respiratory System
  • Practice Guidelines as Topic
  • Humans
  • Decision Trees
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences