Weaning the long-term ventilator-dependent patient: common problems and management

Weaning methods are an important ingredient in successful extubation. All too frequently, however, patient problems that thwart weaning are not identified or controlled. The pre-weaning assessment form in Table 2 should be used as an evaluation tool after the patient is intubated. Any "no" answers will indicate a common problem impeding weaning. Following problem identification, a plan of care can be developed using management strategies described in Table 3. Thus, a critical void in practice, impediments to weaning, is addressed. This article has addressed the need for the prevention or early identification of problems in mechanically ventilated patients. With this knowledge to guide our practice, we should be able to wean almost any patient.