Mechanical Ventilation: Beyond the ICU

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Ventilator Dependence

"Weaning" is the word used to describe the process of gradually removing the patient from the ventilator and restoring spontaneous breathing after a period of mechanical ventilation. Physicians and the ICU respiratory care specialists help patients to wean when weaning is determined to be medically appropriate. While patients with some conditions can be weaned from mechanical ventilation after a few days to a week in the ICU, patients with other conditions cannot or should not be taken off the ventilator. Patients with stable chronic medical conditions are more likely to require long-term mechanical ventilation, for example, patients with neuromuscular disorders or chest wall deformities.

Mechanical ventilation is required when a patient's spontaneous efforts are unable to sustain adequate ventilation of the lungs.

Conditions such as stroke and spinal cord injury damage the nerves that control breathing and make spontaneous breathing impossible for an extended period or for life.

Chronic stable illnesses, such as neuromuscular disorders and chest wall deformities, and/or advanced age, may make long-term mechanical ventilation necessary for extended periods or for life.

Chronic illness that requires recurrent ICU hospitalization may require frequent repeated treatments with mechanical ventilation and repeated attempts to wean from mechanical ventilation.

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