ABSTRACT
Patients who require mechanical ventilation (MV) are patients with respiratory failure. Patients who recover quickly from the original problem that led to their respiratory failure can be liberated from the ventilator easily in most cases. The barriers to weaning that we observe frequently include: inadequate MV, cardiac disease, infection, fluid overload, nutritional deficiency, and neurological dysfunction. If patients meet the criteria, a trial of spontaneous breathing or a gradual reduction of pressure support may be attempted. The use of non-invasive ventilation as a rescue modality in patients with respiratory failure following extubation fails to prevent reintubation and is associated with increased mortality. Extubation directly to a high-flow nasal cannula for patients with a high risk of post-extubation respiratory failure was found to be effective in preventing respiratory failure and in reducing the rate of reintubation. Nutritional deficiency may weaken the respiratory muscles and reduce their work capacity.
