ABSTRACT

The physician concerned with weaning a patient from mechanical ventilation must address two important questions: I) When is it appropriate to initiate the weaning process? and 2) Which of the many weaning strategies is most efficacious? During the past five years. several prospective controlled randomized clinical trials have address questions of weaning strategy and outcomes. However. the relevance of these trials for weaning from long-tenn mechanical ventilation is not clear because most of the study participants had acute and imminently reversible fonns of respiratory failure.