对意外或自主拔管患者的研究显示，接受完全机械通气患者的23％和开始撤机过程患者的69％并不需要重新插管，这表明机械通气患者的撤机存在被延迟的倾向，致使患者承受不必要的痛苦，增加了并发症的发生率和医疗费用。撤机过程所耗费的时间占机械通气整个时间的40％~50％ 。Esteban等的研究证明：延长通气时间增加病死率。在美国，机械通气的费用约2 000美元／d，延长通气者占总机械通气患者的6％，但却消耗ICU资源的37％。我国的撤机现状与之类似，日益增多的撤机困难患者占用各ICU的有限资源，成为医疗费用和床位周转的沉重负担。机械通气撤离的研
究亟待加强。
Citation：
YU Senyang. Strengthening research in mechanical ventilation weaning. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(4): 242-244. doi:
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Boles JM，Bion J，Connors A，et al.Weaning from mechanical ventilation.Eur Respir J，2007，29：1033-1056.
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Saura P，Blanch L，Mestre J，et al.Clinical consequences of the implementation of a weaning protocol.Intensive Care Med，1996，22：1052-1056.
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Krishnan JA，Moore D，Robeson C，et al.A prospective，controlled trial of a protocol-based strategy to discontinue mechanical ventilation.Am J Respir Crit Care Med，2004，169：673-678.
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Burns KE，Adhikari NK，Meade MO.A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation.Can J Anesth，2006，53：305-315.
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Peter JV，Moran JL，Phillips-Hughes J，et al.Noninvasive ventilation in acute respiratory failure--a meta-analysis update.Crit Care Med，2002，30：555-562.
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Tobin MJ，Jubran A.Meta-analysis under the spotlight：focused on a meta-analysis of ventilator weaning.Crit Care Med，2008，36：1-7.
|
- 1. Epstein SK，Nevins ML，Chung J.Effect of unplanned extubation on outcome of mechanical ventilation.Am J Respir Crit Care Med，2000，161：1912-1916.
- 2. Esteban A，Anzueto A，Frutos F，et al．Mechanical ventilation international study group．Characteristics and outcomes in adult patients receiving mechanical ventilation：a 28-day international study．JAMA，2002，287：345-355．.
- 3. Cooper LM，Linde-Zwirble WT.Medicare intensive care unit use：analysis of incidence，cost，and payment.Crit Care Med，2004，32：2247-2253.
- 4. Wagner DP.Economics of prolonged mechanical ventilation.Am Rev Respir Dis，1989，140：S14-S18.
- 5. MacIntyre NR，Cook DJ，Ely EW Jr，et al.Evidence-based guidelines for weaning and discontinuing ventilatory support：a collective task force facilitated by the American College of Chest Physicians；the American Association for Respiratory Care；and the American College of Critical Care Medicine.Chest，2001，120(6 Suppl)：375S-395S.
- 6. Boles JM，Bion J，Connors A，et al.Weaning from mechanical ventilation.Eur Respir J，2007，29：1033-1056.
- 7. Saura P，Blanch L，Mestre J，et al.Clinical consequences of the implementation of a weaning protocol.Intensive Care Med，1996，22：1052-1056.
- 8. Krishnan JA，Moore D，Robeson C，et al.A prospective，controlled trial of a protocol-based strategy to discontinue mechanical ventilation.Am J Respir Crit Care Med，2004，169：673-678.
- 9. Burns KE，Adhikari NK，Meade MO.A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation.Can J Anesth，2006，53：305-315.
- 10. Peter JV，Moran JL，Phillips-Hughes J，et al.Noninvasive ventilation in acute respiratory failure--a meta-analysis update.Crit Care Med，2002，30：555-562.
- 11. Tobin MJ，Jubran A.Meta-analysis under the spotlight：focused on a meta-analysis of ventilator weaning.Crit Care Med，2008，36：1-7.
