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Weaning ventilatory support 

Weaning ventilatory support
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date: 27 November 2020

Several studies suggest that most patients weaned successfully could have tolerated the weaning attempts had they been initiated a day or so earlier. Such data emphasize the need for the early use of screening tests. A screening test should have a high sensitivity. The ratio of respiratory frequency to tidal volume has been evaluated in more than 25 studies and its average sensitivity is 0.89. Weaning involves undertaking three diagnostic tests in sequence, measuring predictors, a weaning trial, and a trial of extubation. Of the techniques used for a weaning trial, intermittent mandatory ventilation has been repeatedly shown to be inferior to the use of T-tube trials or pressure support. Six randomized trials have evaluated the usefulness of protocols in the management of weaning. Three revealed no benefit—two had major methodological problems, leaving only one supporting the use of protocols.

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