الفهرس 
Respiratory physiologyOnly 14 pages are availabe for public view
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Abstract
COPD is a progressive disorder characterized by intermittent episodes of acute exacerbations, each of which has the potential for producing respiratory failure and a need for mechanical ventilation. The decision to intubate a patient with severe underlying COPD requires a blending of the physician’s estimation of prognosis with the patient’s life goals, values, and self-perceived quality of life.
Also weaning or, as some physicians prefer, ”liberation from mechanical ventilation” is an important issue as unnecessary delays in the withdrawal of mechanical ventilatory support increase the patient’s risks for complications and increase the length of ICU stay and hospital costs, also premature withdrawal from the ventilator can also be deleterious. So this issue also should not be performed without certain outlined strategy. Reintubation has the hazards of poor prognosis, with hospital mortality exceeding 30 to 40%.
To minimize the likelihood of either delayed weaning or premature extubation, a two-step diagnostic strategy is recommended: measurement of weaning predictors followed by a weaning trial. Spontaneous breathing trial has gained popularity in the past few years as the goal for most patients on mechanical ventilation is to be weaned from the ventilator. The weaning process is highly dependent on the patient’s pathology, but the final common pathway to ventilator independence always includes at least one trial of spontaneous breathing. Trials of spontaneous breathing have been shown to accurately predict the success of spontaneous breathing.