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1 From the Pulmonary and Critical Care Division, University of Chicago
2 From the Bridgeport Hospital and Yale University School of Medicine, Bridgeport, Conn, and the Section of Pulmonary and Critical Care, University of Chicago
Multiple complications associated with mechanical ventilation mandate that clinicians expeditiously define and reverse the pathophysiologic processes that precipitate respiratory failure and then, detect the earliest point that a patient can breathe without the ventilator. Over the past decade, numerous laboratory and clinical studies have been reported that may inform transformation of the "art of weaning" to the science of liberation. We review these studies and use them to formulate a systematic approach to assure early, safe, and successful liberation of patients from mechanical ventilation.
Key Words: hypoxemia • hypercapnia • liberation • mechanical ventilation • respiratory failure • weaning
Submitted on August 21, 1997
Accepted on March 6, 1998
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