Weaning smokers from mechanical ventilation.

Because smoking causes oxidant stress, inflammation, and protease-antiprotease imbalance of the lung tissue, smokers may have a lower threshold for initiation of mechanical ventilation. Critical care team members should realize that not only the pulmonary system is compromised but also other protective response mechanisms of the body. Therefore, the role of every critical care team member is pivotal to ensure a successful weaning and extubation process for smokers. This article addresses how to best do that with a collaborative and evidence-based approach.