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Archivos de Medicina de Urgencia de México

2026, Number 1

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Arch Med Urg Mex 2026; 18 (1)

Weaning: from mechanical ventilation: where are we and where are we going? The significance of an individualized protocol

Hernández-López GD, Gorordo-Delsol LA

Language: Spanish
References: 46
Page: 79-86
PDF size: 307.51 Kb.


ABSTRACT

Weaning, or the withdrawal from mechanical ventilation, is a crucial process in the recovery of critically ill patients. Approximately 40% of the time a patient spends on mechanical ventilation is dedicated to this process, highlighting its importance in avoiding complications related to prolonged ventilation, such as respiratory infections, lung damage, and muscle weakness. A structured weaning protocol is essential to guide healthcare professionals in identifying the appropriate time to initiate the process, as well as selecting the most appropriate tools to assess the patient’s ability to breathe independently. However, the key to successful weaning lies in individualizing the protocol. Each patient presents unique characteristics and clinical conditions that must be considered when planning their withdrawal from mechanical ventilation. This individualization helps reduce the risk of extubation failure, minimizing the need for reintubation and optimizing clinical outcomes. Factors such as the underlying disease, the duration of ventilation, diaphragmatic strength, cardiovascular status, age, and comorbidities, among others, influence the patient’s ability to be successfully extubated. Therefore, it is necessary to personalize the approach, avoiding the routine and generalized application of a single protocol for all patients. Having a weaning protocol is essential to guide the process, but its success depends on its adaptation to the specific needs and conditions of each patient, allowing for a safe and efficient withdrawal from mechanical ventilation.


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