الفهرس 
Physiology of the Respiratory SystemOnly 14 pages are availabe for public view
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Abstract
Background: Mechanical ventilation offers essential ventilatory support, while the respiratory system recovers from acute respiratory failure. Yet, invasive mechanical ventilation is associated with risks and complications that prolong the duration of mechanical ventilation and increase the risk of death.
Aim of the Work: The aim of this essay is to discuss the recent definitions, pathophysiology, new predictors and guidelines of management of prolonged mechanical ventilation.
Summary: According to the European Respiratory Society Task Force: prolonged weaning patients are those requiring more than 7 days of weaning after the first spontaneous breathing trial.
The pathophysiologic mechanisms of weaning failure need to be understood for an optimal management of the patient. These mechanisms include respiratory pump insufficiency, cardiovascular dysfunction, neuromuscular disorders, psychological factors as well as metabolic and endocrine diseases, alone or combined.
After a failed weaning test or extubation failure, a ventilation mode allowing a supposedly normal level of work of breathing is resumed. A thorough diagnostic work-up is then carried out. Subsequently, all reversible pathologies met are corrected, weaning readiness regularly ascertained and the weaning test is repeated. Tracheostomy may be considered as a useful adjunct for an easier care of the patient, especially for mobilization