TY - CHAP M1 - Book, Section TI - Controversies: Ventilator Weaning—Which Strategy is Better? RT-RN Versus Physician Driven A1 - Lee, Ilde Manuel A1 - Voigt, Louis P. A2 - Oropello, John M. A2 - Pastores, Stephen M. A2 - Kvetan, Vladimir Y1 - 1 N1 - T2 - Critical Care AB - The advent of invasive mechanical ventilation (IMV) has been one of the greatest achievements in the field of respiratory and critical care medicine. In the United States alone, there were 790,257 hospitalizations involving IMV in 2005, and that number is expected to steadily increase, outpacing population growth by 2026.1,2 Although advances in medical technology have facilitated the management of patients who require ventilatory support, mechanical ventilation remains associated with risks and complications.3 Thus, once clinical improvement occurs, significant emphasis is placed on rapidly weaning the patient from IMV. Over the past 25 years, numerous trials have evaluated the most effective approach to liberate patients from IMV, including the use of protocol-based weaning (PBW). Compared to physician-directed weaning, protocolized strategies driven by nurses and/or respiratory therapists (RTs) have gained general acceptance in many intensive care units (ICUs) because of reduction in morbidity, mortality, and health-care costs (Table 65–1).4,5,6 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1136418153 ER -