Assessment of weaning failure from prolonged mechanical ventilation
Case report
Abstract
Introduction: Due to advances in intensive care, a significant number of patients have survived the acute phase of their critical illness. However, chronically critically ill patients require continuous life support. This case report presents the clinical characteristics and evolution of a patient with weaning failure from mechanical ventilation (MV) who was admitted to a weaning and rehabilitation center (WRC). The objective of this case report is to describe the assessment and to relate alterations to possible causes of weaning failure.
Case presentation: An 82-year-old female was admitted to a WRC after prolonged weaning due to severe community-acquired pneumonia. An assessment strategy based on Heunks and Hoeven’s approach was used. According to the assessment, alterations in lung parenchyma and the presence of an abnormal respiratory response to induced hypercapnia could be the reasons for mechanical ventilation dependency.
Conclusion: The application of an assessment strategy showed that alterations in the respiratory mechanics and respiratory drive may be the causes of weaning failure. Assessment algorithms could benefit patients receiving prolonged mechanical ventilation.
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