Liberation from mechanical ventilation: targeted weaning versus daily weaning trials

Critical-care clinicians must carefully weigh the benefits of rapid liberation from mechanical ventilation against the risks of premature trials of spontaneous breathing and extubation. Our aim of work was to study the capability of respiratory system mechanics as weaning parameters. In 30 patients who have been mechanically ventilated due to pulmonary causes of respiratory failure, we divided patients into 2 groups: [Group 1] in which weaning was postponed until certain values of lung mechanics have been reached [targeted weaning], and [Group 2] in which patients undergone daily weaning trials once the general criteria of weaning have been fulfilled irrespective of their lung mechanics values. Targeted weaning threshold values were as follows: static compliance >33ml/cmH[2]O dynamic compliance >22ml/cmH[2]O, resistance 0.05]. Targeted weaning group has showed less number of weaning trials and fewer incidences of re-intubation events with no increase in mechanical ventilation time or complications. We concluded that respiratory mechanics were modest weaning predictors. But on the other hand, targeted weaning by respiratory mechanics constituted a much more economic and resource preserving protocol of weaning