Prolonged Weaning: One Case Report and Literature Review_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 ShiPeng , AnDongshan , SunWeihong , ZhangWeijie

Department of Respiratory Medicine, People's Hospital of Jilin Province, Changchun, Jilin, 130021, China;

Corresponding author：

ShiPeng, Email: shi_peng@yeah.net

Keywords：

Prolonged weaning; Mechanical ventilation

DOI：

10.7507/1671-6205.2015049

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To improve the understanding of prolonged weaning. Methods A clinical case of prolonged weaning who had been successfully weaned from mechanical ventilation was retrospectively analyzed. The related literature was also reviewed. Results The patient received invasive mechanical ventilation for 5 months,diagnosed as ventilator-associated pneumonia,type Ⅱrespiratory failure,Green-Barry syndrome,hypoproteinemia,anemia,and electrolyte disorder. Through the control of infection,nutritional support,psychological counseling,the patient was weaned from ventilator gradually and succeeded eventually. Conclusions Prolonged weaning is relatively difficult and wastes a long time. Professional treatment team and specialized treatment room are necessory. There are few reports about prolonged weaning.

Citation： ShiPeng, AnDongshan, SunWeihong, ZhangWeijie. Prolonged Weaning: One Case Report and Literature Review. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(2): 194-196. doi: 10.7507/1671-6205.2015049 Copy

1.	Funk GC, Anders S, Breyer MK,et al.Incidence and outcome ofweaning from mechanical ventilation according to new categories. Eur Respir J, 2010,35:88-94.
2.	Sellares J, Ferrer M, Cano E, et al. Predictors of prolonged weaning andsurvival during ventilator weaning in a respiratory ICU. Intensive Care Med, 2011,37:775-784.
3.	Penñuelas O, Frutos-Vivar F, Fernaíndez C, et al. Characteristics and outcomes of ventilated patients according to time to liberation from mechanical ventilation. Am J Respir Crit Care Med, 2011,184:430-437.
4.	Macintyre NR. Chronic critical illness:the growing challenge to health care. Respir Care, 2012,57:1021-1027.
5.	Polverino E, Nava S, Ferrer M, et al. Patients' characterization, hospital course and clinical outcomes in five Italian respiratory intensive care units.Intensive Care Med, 2010,36:137-142.
6.	Boles JM, Bion J, Connors A, et al. Weaning from me chanical ventilation. Eur Respir J,2007, 29:1033-1056.
7.	詹庆元,罗祖金,童朝辉,等.长期呼吸机依赖患者成功脱机一例体会,中华医学杂志,2006,86:2221-2223.
8.	Maramattom BV,Wijdicks EF.Acute neuromuscular weakness in the intensive care unit.Crit Care Med, 2006, 34:2835-2841.
9.	Gutierrez CJ,Harrow J,Haines F.Using an evidence-based protocol to guide rehabilitation and weaning of ventilator-dependent cervical spinal cord injury patients.J Rehabil Res Dev,2003,40:99-110.
10.	Vassilakopoulos T,Petrof BJ.Ventilation-induced diaphragm dysfunction.Am J Respir Care Med,2004,169:336-341.
11.	Powers SK,Kavazis AN,Levine Sanford,et al. Prolonged mechanical ventilation alters diaphra gmatic structure and function. Crit Care Med,2009,37(10 Suppl):S374-353.
12.	Zhu E,Sassoon CS,Nelson R,et al.Early effects of mechanical ventilation on isotonic contractile properties and MAF-box gene expression in the diaphragm.J Appl Physiol,2005,99:747-756.
13.	Schweickert WD, Pohlman MC,Pohlman AS, et al. Early physicaland occupational therapy in mechanically ventilated, critically ill patients:a randomised controlled trial. Lancet,2009, 373:1874-1882.
14.	马迎民.影响机械通气撤离的因素与临床实施流程.中华结核与呼吸杂志,2013,36:710-711.
15.	Jubran A, Lawm G, Kelly J, et al. Depressive disorders during weaning from prolonged mechanical ventilation.Intensive Care Med,2010,36:828-835.
16.	Jubran A, Grant BJ, Duffner LA,et al. Effect of pressure support vs unassisted breathing through a tracheostomy collar on weaning duration in patients requiring prolonged mechanical ventilation:a randomized trial. JAMA,2013, 309:671-677.
17.	Macintyre NR.Evidence-based ventilator weaning and discontinuation.Respir Care,2004,49:830-836.
18.	Perren A, Brochard L.Managing the apparent and hidden difficulties of weaning from mechanical ventilation. Intensive Care Med,2013,39:1885-1895.
19.	Barchfeld T, Dellweg D, Böckling S,et al. Weaning from long-term mechanical ventilation:data of a single weaning center from 2007 to 2011.Dtsch Med Wochenschr, 2014, 139:527-533.

1. Funk GC, Anders S, Breyer MK,et al.Incidence and outcome ofweaning from mechanical ventilation according to new categories. Eur Respir J, 2010,35:88-94.
2. Sellares J, Ferrer M, Cano E, et al. Predictors of prolonged weaning andsurvival during ventilator weaning in a respiratory ICU. Intensive Care Med, 2011,37:775-784.
3. Penñuelas O, Frutos-Vivar F, Fernaíndez C, et al. Characteristics and outcomes of ventilated patients according to time to liberation from mechanical ventilation. Am J Respir Crit Care Med, 2011,184:430-437.
4. Macintyre NR. Chronic critical illness:the growing challenge to health care. Respir Care, 2012,57:1021-1027.
5. Polverino E, Nava S, Ferrer M, et al. Patients' characterization, hospital course and clinical outcomes in five Italian respiratory intensive care units.Intensive Care Med, 2010,36:137-142.
6. Boles JM, Bion J, Connors A, et al. Weaning from me chanical ventilation. Eur Respir J,2007, 29:1033-1056.
7. 詹庆元,罗祖金,童朝辉,等.长期呼吸机依赖患者成功脱机一例体会,中华医学杂志,2006,86:2221-2223.
8. Maramattom BV,Wijdicks EF.Acute neuromuscular weakness in the intensive care unit.Crit Care Med, 2006, 34:2835-2841.
9. Gutierrez CJ,Harrow J,Haines F.Using an evidence-based protocol to guide rehabilitation and weaning of ventilator-dependent cervical spinal cord injury patients.J Rehabil Res Dev,2003,40:99-110.
10. Vassilakopoulos T,Petrof BJ.Ventilation-induced diaphragm dysfunction.Am J Respir Care Med,2004,169:336-341.
11. Powers SK,Kavazis AN,Levine Sanford,et al. Prolonged mechanical ventilation alters diaphra gmatic structure and function. Crit Care Med,2009,37(10 Suppl):S374-353.
12. Zhu E,Sassoon CS,Nelson R,et al.Early effects of mechanical ventilation on isotonic contractile properties and MAF-box gene expression in the diaphragm.J Appl Physiol,2005,99:747-756.
13. Schweickert WD, Pohlman MC,Pohlman AS, et al. Early physicaland occupational therapy in mechanically ventilated, critically ill patients:a randomised controlled trial. Lancet,2009, 373:1874-1882.
14. 马迎民.影响机械通气撤离的因素与临床实施流程.中华结核与呼吸杂志,2013,36:710-711.
15. Jubran A, Lawm G, Kelly J, et al. Depressive disorders during weaning from prolonged mechanical ventilation.Intensive Care Med,2010,36:828-835.
16. Jubran A, Grant BJ, Duffner LA,et al. Effect of pressure support vs unassisted breathing through a tracheostomy collar on weaning duration in patients requiring prolonged mechanical ventilation:a randomized trial. JAMA,2013, 309:671-677.
17. Macintyre NR.Evidence-based ventilator weaning and discontinuation.Respir Care,2004,49:830-836.
18. Perren A, Brochard L.Managing the apparent and hidden difficulties of weaning from mechanical ventilation. Intensive Care Med,2013,39:1885-1895.
19. Barchfeld T, Dellweg D, Böckling S,et al. Weaning from long-term mechanical ventilation:data of a single weaning center from 2007 to 2011.Dtsch Med Wochenschr, 2014, 139:527-533.

Chinese Journal of Respiratory and Critical Care Medicine

Prolonged Weaning: One Case Report and Literature Review

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