ReviewIntensive care medicine2013
Managing the apparent and hidden difficulties of weaning from mechanical ventilation.
Review in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 137 citations in OpenAlex.
- Comparison of T-piece and pressure support ventilation as spontaneous breathing trials in critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2020Pooled it
- A systematic review of interventions to facilitate extubation in patients difficult-to-wean due to delirium, agitation, or anxiety and a meta-analysis of the effect of dexmedetomidine.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2019Pooled it
- Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation.The Cochrane database of systematic reviews · 2017Pooled it
- Association between abdominal muscle weakness and weaning failure in mechanically ventilated critically ill patients: an ultrasound assessment.Journal of anesthesia, analgesia and critical care · 2026Article
- Ventilator Settings and Monitoring Variables Associated with Extubation Failure in Critically Ill Patients: A Retrospective Cohort Study.Critical care science · 2026Observational
- Effect of positive end-expiratory pressure on risk of microaspiration and ventilator-associated pneumonia in mechanically ventilated ICU patients: a prospective study.Journal of cardiothoracic surgery · 2025Article
- Transcutaneous Carbon Dioxide Monitoring During Weaning From Mechanical Ventilation in Children: The WeanCOPediatric pulmonology · 2025Article
- Predictive model for postoperative pneumonia in patients with esophageal cancer after esophagectomy.Frontiers in oncology · 2025Article
- Weaning management in a patient with heart dysfunction: a case report.Frontiers in physiology · 2025Article
- Contribution and evolution of respiratory muscles function in weaning outcome of ventilator-dependent patients.Critical care (London, England) · 2024Article
- Tissue Doppler imaging of the diaphragm and outcome of weaning from mechanical ventilation.Australasian journal of ultrasound in medicine · 2024Article
- Risk factors for long-term invasive mechanical ventilation: a longitudinal study using German health claims data.Respiratory research · 2024Article
- Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial.Critical care (London, England) · 2023Observational
- Physiological effects of high-flow nasal cannula oxygen therapy after extubation: a randomized crossover study.Annals of intensive care · 2023Article
- Development of a Machine Learning Model for Predicting Weaning Outcomes Based Solely on Continuous Ventilator Parameters during Spontaneous Breathing Trials.Bioengineering (Basel, Switzerland) · 2023Article
- Wean to Win.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Mitral regurgitation in the critically ill: the devil is in the detail.Annals of intensive care · 2023Review
- Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross-sectional study.Health science reports · 2023Article
- Cardiopulmonary interactions during ventilator weaning.Frontiers in physiology · 2023Review
- The physiological underpinnings of life-saving respiratory support.Intensive care medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn anaesthetized patients scheduled for surgery, tracheal intubation is performed with the expectation of subsequent smooth extubation. In critically ill patients, separation from the ventilator is often gradual and the time chosen for extubation may be either delayed or premature. Thus, weaning is challenging, represents a large part of the ventilation period and concerns all mechanically ventilated patients surviving their stay. DEFINITIONS AND MANAGEMENT: Weaning may be stratified in three groups according to its difficulty and duration. In simple weaning the main issue is to detect the soonest time to start separation from the ventilator; this is frequently impeded by poor sedation management and excessive ventilator assistance. A two-step diagnostic approach is the most efficacious: screening for ascertained readiness to wean is confirmed by a diagnostic test simulating the post-extubation period, best performed by unassisted breathing (no PEEP). In case of test failure (difficult weaning), a structured and thorough diagnostic work-up regarding potentially reversible pathologies is required with a focus on cardiovascular dysfunction or fluid overload at the time of separation from the ventilator, respiratory or global muscle weakness and underlying infection. Prolonged weaning is exceptionally time- and resource-consuming, needs to properly appraise psychological problems, sleep and nutrition, and is probably best performed in specialized units.
conclusionsAdequately managing simple and difficult weaning requires one to think about ICU policies in terms of sedation, fluid balance and having a systematic screening strategy; it also needs an individualized approach to understand and treat the failing patients. Prolonged weaning requires a holistic approach.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.