Monitoring weaning from mechanical ventilation in the critically ill patient

The weaning process can be classified as simple, difficult, or prolonged. The incidence of difficult or prolonged weaning varies from 15% to 25%, according to the series. Incritically ill patients it accounts for up to 50% of the total time that they are connected to theventilator. It is very important to monitor weaning to detect the patients in whom it will beprolonged, and to help us in their management and decision making. Firstly, gas exchange andventilatory mechanics must be monitored, fundamental in all patients on mechanical ventilation(MV). In addition, monitoring specific parameters that provide information on the patient's respiratory effort is strategic in the weaning process. These parameters include occlusion pressure(P0.1), oesophageal pressure (Poes), Negative Inspiratory Force (NIF), also known as MaximumInspiratory Pressure (MIP), diaphragmatic electric activity (Edi), total work of breathing (WOB), and its components, elastic WOB (eWOB), and resistive WOB (rWOB). Monitoring weaning frommechanical ventilation means we can establish when the conditions have been met to start theweaning process, propose a weaning protocol adapted to the conditions of the patient, anddefine our post-extubation respiratory care protocol to prevent weaning failure. (c) 2022 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor.