Liberating patients from ongoing invasive mechanical ventilation is typically a 3-step process. First, clinicians must recognize that patients may no longer require mechanical ventilation—ie, when the reasons for intubation are substantially improved and a number of clinical stability criteria are met. Second, patients who meet these “readiness to wean” criteria are then assessed for their ability to breathe through the endotracheal tube with little or no assistance from the ventilator during a so-called spontaneous breathing trial (SBT). Third, for patients who pass their SBT, clinicians must judge whether those patients will be able to sustain ventilation once the endotracheal tube has been removed, maintaining airway patency and clearance of secretions.
Telias I, Ferguson ND. Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients. JAMA. 2019;322(15):1455–1457. doi:10.1001/jama.2019.14609
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