الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
mechanical ventilation is indicated when the patient’s spontaneous ventilation is inadequate to maintain life. It is also indicated as prophylaxis for imminent collapse of other physiologic functions, or ineffective gas exchange in the lungs. Because mechanical ventilation only serves to provide assistance for breathing and does not cure a disease, the patient’s underlying condition should be correctable and should resolve over time. In addition, other factors must be taken into consideration because mechanical ventilation is not without its complications. Weaning from mechanical ventilation can be defined as the process of abruptly or gradually withdrawing ventilatory support. However, two large trials have demonstrated that mechanical ventilation can be abruptly discontinued in 75% of patients whose underlying cause of respiratory failure has either improved or resolved. Hence, the term discontinuation is preferable though the term weaning continues to remain popular. The modes of ventilation can be thought of as classifications based on how to control the ventilator breath. Traditionally ventilators were classified based on how they determined when to stop giving a breath. As microprocessor technology is incorporated into ventilator design, the distinction among these types has become less clear as ventilators may use combinations of all of these modes as well as flow-sensing, which controls the ventilator breath based on the flow-rate of gas versus a specific volume, pressure, or time. As ventilator technology has advanced, newer modes have been developed. Some are variations of volume or pressure modes and some are completely unrelated to conventional mechanical ventilation.
Objectives: The aim of this work is to discuss the causes of difficult weaning and the management plan of patients who are difficult-to-wean, from mechanical ventilation using different methods and techniques.