chapter  11
10 Pages

Weaning using non-invasive ventilation

ByB Schönhofer

Some pathophysiological aspects of weaning failure 134

NIV – an alternative to invasive mechanical ventilation in difficult weaning? 134

Studies of weaning using NIV 136

Weaning in acute hypoxaemic respiratory failure 138

Meta-analysis of weaning using NIV 138

Long-term NIV after weaning 139

Practical aspects 139

Conclusions 139

References 139

In the majority of patients on mechanical ventilation, withdrawal and extubation are possible and they can be weaned from the ventilator successfully within a short period of time. Despite the lack of a widely accepted definition, about 10 per cent of patients with mechanical ventilation require prolonged respiratory support (i.e. they are difficult to wean).1 In this population around 40 per cent of the total time of mechanical ventilation was devoted to weaning2 and more than 50 per cent of the available resources of an ICU are consumed by this process. The most important diseases and conditions that lead to difficult weaning are chronic obstructive pulmonary disease (COPD), cardiac failure, neuromuscular diseases, polytrauma, multi-organ failure and post-operative complications.