Ask the Doctor: Going "Off the Vent"

QBecause of her complex heart and lung issues, my sister was admitted into a long-term care hospital and put on ventilation. Will she have to stay on the vent forever?  

A: Prolonged mechanical ventilation (PMV) – which is defined as “mechanical ventilation for over 6 hours a day for more than 21 days” – can impose a heavy burden (both financially and socially) to the healthcare system, patients, and their families. Like your sister, most patients on (PMV) have multiple diseases and/or conditions that complicate treatment and care.  Having multiple comorbidities requires coordinated treatment and management – not only so that patients receive the best care possible, but so that they can safely and effectively be liberated from PMV. For patients like your sister, the best approach is a multidisciplinary approach that includes physicians, nurses, respiratory therapists, physical therapists, nutrition experts, psychologists, and social workers. This will ensure, besides the best conventional treatments, the appropriate selection of suitable ventilator modes, ventilator settings, and physical, nutritional, and psychological therapies – all things that can help speed up the “weaning” process. Successful weaning rates in PMV range tremendously, anywhere from 42% to 83%, depending on patient selection, site of care, and other factors. Weaning protocols have helped to standardize the process –  but further identification of your sister’s unique issues can allow for better individualized treatment and weaning strategies.

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Michael T. Czarnecki, M.D., “The Lung Doc,” Director of Pulmonary Care - Kindred Hospital Pulmonary & Critical Care Consultants of Chattanooga Locations in Downtown Chattanooga, East Ridge, and Jasper 423.710.3864, thelungdocs.com

Michael T. Czarnecki, M.D., “The Lung Doc,” Director of Pulmonary Care – Kindred Hospital
Pulmonary & Critical Care Consultants of Chattanooga
Locations in Downtown Chattanooga, East Ridge, and Jasper
423.710.3864, thelungdocs.com

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