The Difficult-to-wean Patient

Nicolino Ambrosino; Luciano Gabbrielli


Expert Rev Resp Med. 2010;4(5):685-692. 

In This Article


Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on MV and other intensive care therapies.[81] Chronic critical illness is a devastating condition: mortality exceeds that for most malignancies, while functional dependence persists for most survivors. Costs of treating the chronically critically ill in the USA already exceed US$20 billion and are increasing.[5] Long-term weaning units may be cost-effective alternatives to acute ICUs in the management of difficult-to-wean patients. Several observational studies estimate lower daily costs of care for ventilator-dependent patients in WC, primarily through reduced need of personnel, and reduced costs for monitoring (e.g., noninvasive), technical equipment (e.g., portable ventilators), diagnostics and therapeutics.[11,32,82]


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