Mechanical ventilation weaning is a process in which a patient on a mechanical ventilator is gradually or suddenly taken off the ventilator, depending on the patient's situation. The goal of weaning is to make sure that it is safe to remove the patient from the ventilator by removing the patient gradually and in a controlled setting. Different hospitals have different protocols about how and when weaning should be done, and a number of scientific studies have been conducted to provide information about how to conduct weaning and some issues to consider while weaning patients from a ventilator.
The mechanical ventilator can be a lifesaving device. A patient on a ventilator has a tube inserted into the trachea, with the ventilator connected to the tube. The ventilator does the breathing for the patient. If a patient cannot breathe independently, a ventilator is critical. Patients who experience severe difficulty breathing can benefit from a short period of time on a ventilator until the source of their difficulties is identified and resolved.
However, mechanical ventilation is uncomfortable for patients, and it also carries some significant risks. In addition, it's expensive. For all of these reasons, hospitals try to avoid putting patients on ventilators, and they try to get patients off the ventilator with mechanical ventilation weaning as quickly as possible.
When it seems like a patient should be able to breathe independently, the ventilator can be withdrawn in a test during which the patient is closely monitored. If the patient indeed breathes well off the ventilator and an arterial blood gas test reveals that the levels of dissolved gases in the patient's blood are acceptable, the patient can be left off the ventilator. If a patient is breathing acceptably but gases are low, supplemental oxygen through a nasal cannula may be provided.
If a patient struggles off the ventilator, he or she will be put back on the ventilator. In this case, mechanical ventilation weaning will need to begin again, and may be taken in slow steps, recognizing that the patient had trouble with mechanical ventilation weaning the first time. At any time, the patient can be put back on the ventilator if it is clear that independent breathing is not possible.
Being selected for mechanical ventilation weaning is a good sign; it means that hospital personnel think that a patient is getting better. Friends and family members should be aware, however, the patients can experience setbacks. They may want to talk about the prognosis for the patient with the patient's medical care team to learn more about what is going to happen in the coming days, weeks, and months.