Vnitr Lek 2001, 47(9):613-620

[Weaning from artificial pulmonary ventilation].

F Polák, J Bělohlávek, M Hrubý, F Novák: IV. interní klinika Vseobecné fakultní nemocnice, Praha.

Weaning from mechanical ventilation is not complicated in the majority of patients, in some, however, this process is very complicated and lengthy. These patients are described as difficult to wean. A suitable weaning strategy and properly timed extubation or decannulation is important not only from the aspect of the patient's health status but also with regard to costs of care. When selecting patients suitable for weaning it is useful to use prognostic indicators of success. The Tobin-Yang index and ratio Pa O2/FiO2 seem to be most useful. Based on available information it seems that the pressure support and weaning by means of T-piece is more effective than weaning using the SIMV regime. Promising seems the use of non-invasive ventilation but this was not proved unequivocally so far. The use of weaning protocols reduces the weaning period from mechanical ventilation. The authors summarize most recent findings on the weaning problem incl. the most frequently used ventilation regimes and prognostic indicators of successful weaning.