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

Evidence-based assessments in the ventilator discontinuation process.

Publication ,  Journal Article
Macintyre, NR
Published in: Respir Care
October 2012

The ventilator discontinuation process is an essential component of overall ventilator management. Undue delay leads to excess stay, iatrogenic lung injury, unnecessary sedation, and even higher mortality. On the other hand, premature withdrawal can lead to muscle fatigue, dangerous gas exchange impairment, loss of airway protection, and also a higher mortality. An evidence-based task force has recommended a daily discontinuation assessment and management process for most ICU patients requiring at least 24 hours of mechanical ventilator support. This process focuses on assessments on the causes for ventilator dependence, assessments for evidence of disease stability/reversal, use of regular spontaneous breathing trials (SBTs) as the primary assessment tool for ventilator discontinuation potential, use of separate assessments to evaluate the need for an artificial airway in patients tolerating the SBT, and the use of comfortable, interactive ventilator modes (that do not need to be "weaned") in between regular SBTs. More recent developments have focused on the utility of computer decision support to guide these processes and the importance of linking sedation reduction protocols to ventilator discontinuation protocols. These guidelines are standing the test of time, and practice patterns are evolving in accordance with them. Nevertheless, there is still room for improvement and need for further clinical studies, especially in the patient requiring prolonged mechanical ventilation.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Respir Care

DOI

ISSN

0020-1324

Publication Date

October 2012

Volume

57

Issue

10

Start / End Page

1611 / 1618

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • Respiratory System
  • Humans
  • Guidelines as Topic
  • Evidence-Based Medicine
  • Critical Care
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Macintyre, N. R. (2012). Evidence-based assessments in the ventilator discontinuation process. Respir Care, 57(10), 1611–1618. https://doi.org/10.4187/respcare.02055
Macintyre, Neil R. “Evidence-based assessments in the ventilator discontinuation process.Respir Care 57, no. 10 (October 2012): 1611–18. https://doi.org/10.4187/respcare.02055.
Macintyre NR. Evidence-based assessments in the ventilator discontinuation process. Respir Care. 2012 Oct;57(10):1611–8.
Macintyre, Neil R. “Evidence-based assessments in the ventilator discontinuation process.Respir Care, vol. 57, no. 10, Oct. 2012, pp. 1611–18. Pubmed, doi:10.4187/respcare.02055.
Macintyre NR. Evidence-based assessments in the ventilator discontinuation process. Respir Care. 2012 Oct;57(10):1611–1618.

Published In

Respir Care

DOI

ISSN

0020-1324

Publication Date

October 2012

Volume

57

Issue

10

Start / End Page

1611 / 1618

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • Respiratory System
  • Humans
  • Guidelines as Topic
  • Evidence-Based Medicine
  • Critical Care
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology