Weaning from mechanical ventilation is the process of reducing ventilatory support which can result in in a patient breathing spontaneously and being extubated. When the original cause of respiratory failure has improved, this can be achieved rapidly in ∼80% of patients. The remaining cases will require a more gradual method of withdrawing ventilation.
The length of time on mechanical ventilation is directly correlated with the incidence of potentially serious complications such as ventilator associated pneumonia (VAP) and airway trauma.([FOOTNOTE=McLean, S. E., Jensen, L. A., Schroeder, D. G., Gibney, N. R., & Skjodt, N. M. Improving adherence to a mechanical ventilation weaning protocol for critically ill adults: outcomes after an implementation program. Am J Crit Care. 2006;15(3):299-309.],[ANCHOR=],[LINK=])
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The weaning process itself can be quite lengthy, often accounting for approximately 25% of the total time on the ventilator.([FOOTNOTE=Blackwood, B., Burns, K. E., Cardwell, C. R., & O'Halloran, P. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev. 2014(11):CD006904.],[ANCHOR=],[LINK=])
Protocol-driven weaning has been shown to reduce the time spent on mechanical ventilation by 26% on average compared to clinician driven, non-protocolized weaning.2