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Review
. 2024 Apr;40(2):391-408.
doi: 10.1016/j.ccc.2024.01.007. Epub 2024 Feb 6.

Ventilator Weaning and Extubation

Karen E A Burns  1 , Bram Rochwerg  2 , Andrew J E Seely  3
Affiliations
Review

Ventilator Weaning and Extubation

Karen E A Burns et al. Crit Care Clin. 2024 Apr.

Abstract

Increasing evidence supports specific approaches to liberate patients from invasive ventilation including the use of liberation protocols, inspiratory assistance during spontaneous breathing trials (SBTs), early extubation of patients with chronic obstructive pulmonary disease to noninvasive ventilation, and prophylactic use of noninvasive support strategies after extubation. Additional research is needed to elucidate the best criteria to identify patients who are ready to undergo an SBT and to inform optimal screening frequency, the best SBT technique and duration, extubation assessments, and extubation decision-making. Additional clarity is also needed regarding the optimal timing to measure and report extubation success.

Keywords: Extubation; High flow nasal cannulae; Noninvasive ventilation; Ventilator weaning.

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Conflict of interest statement

Disclosure K.E.A. Burns holds a Canadian Institutes of Health Research grant to investigate weaning strategies and Physician Services Incorporated Mid Career Research Award. A.J. Seely is the founder and CEO of Therapeutic Monitoring Systems, which holds global licensing rights for intellectual property related to Extubation Advisor (a tool designed to aid extubation assessment) and tools being developed in the Ottawa Hospital Research Institute Dynamical Analysis Laboratory that require regulatory approval and commercialization for bedside application. B. Rochwerg has no conflicts of interest to declare.