Every year, more than 1 million patients throughout the world receive mechanical ventilation for acute respiratory failure. One of the most important decisions clinicians make in managing these critically ill patients is how to liberate them from invasive ventilation. Ventilator liberation poses an important dilemma for clinicians because premature or failed attempts at extubation, which typically necessitate reintubation, increase rates of ventilator-associated pneumonia, mortality, and other adverse outcomes.1 Conversely, delaying extubation also increases a patient’s risk of being oversedated and developing delirium or ventilator-associated events.2
Girard TD, Burns KEA. Revisiting, Reframing, and Casting a New Light on Liberation From Mechanical Ventilation. JAMA. 2019;321(22):2167–2169. doi:10.1001/jama.2019.7364
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