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Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines.

作者信息

Ha Tae Sun, Oh Dong Kyu, Lee Hak-Jae, Chang Youjin, Jeong In Seok, Sim Yun Su, Hong Suk-Kyung, Park Sunghoon, Suh Gee Young, Park So Young

机构信息

Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Department of Pulmonology, Dongkang Medical Center, Ulsan, Korea.

出版信息

Acute Crit Care. 2024 Feb;39(1):1-23. doi: 10.4266/acc.2024.00052. Epub 2024 Feb 28.


DOI:10.4266/acc.2024.00052
PMID:38476061
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11002621/
Abstract

BACKGROUND: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. METHODS: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. RESULTS: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. CONCLUSIONS: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

摘要

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引用本文的文献

[1]
Comparison of High Versus Low Positive End-Expiratory Pressure in Mechanically Ventilated Patients With Acute Heart Failure: Rationale and Design of the HELP-AHF Trial.

Int J Heart Fail. 2025-4-23

[2]
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BMC Anesthesiol. 2025-3-15

[3]
Comparison of programmed sedation care with conventional care in patients receiving mechanical ventilation for acute respiratory failure.

Ir J Med Sci. 2025-2

本文引用的文献

[1]
Pressure support and positive end-expiratory pressure versus T-piece during spontaneous breathing trial in difficult weaning from mechanical ventilation: study protocol for the SBT-ICU study.

Trials. 2022-12-12

[2]
Spontaneous-Breathing Trials with Pressure-Support Ventilation or a T-Piece.

N Engl J Med. 2022-11-17

[3]
Prolonged Mechanical Ventilation: Outcomes and Management.

J Clin Med. 2022-4-27

[4]
High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.

Crit Care. 2022-4-15

[5]
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit.

Acute Crit Care. 2022-2

[6]
High-flow nasal cannula for respiratory failure in adult patients.

Acute Crit Care. 2021-11

[7]
Comparison between pressure support ventilation and T-piece in spontaneous breathing trials.

Respir Res. 2022-2-7

[8]
ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure.

Eur Respir J. 2022-4-14

[9]
Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study.

Sci Rep. 2021-10-7

[10]
A prospective study on use of thrive (transnasal humidified rapid insufflation ventilatory exchange) versus conventional nasal oxygenation following extubation of adult cardiac surgical patients.

Ann Card Anaesth. 2021

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