ABSTRACT
Patients with COPD account for 13% of all patients receiving mechanical ventila-
tion; COPD is the most common indication for mechanical ventilation in North
America (1). Although often life saving, mechanical ventilation is associated with
several major complications. Accordingly, it is important to discontinue mechanical
ventilation and extubate the patient at the earliest possible time. While it is possible
to wean the majority of patients from mechanical ventilation without much difficulty,
25 to 30% of patients repeatedly fail weaning trials (2, 3). These difficult-to-wean
patients account for a considerable proportion of the workload in an intensive care
unit (ICU) (1). In a survey of ventilator-supported patients, over 40% of total
ventilator time was consumed by weaning the patient from the ventilator (4) and, in
patients with COPD, weaning constituted 59% of the total ventilator time.
