Title
Liberation from Mechanical Ventilation in Critically Ill Adults
Authoring Organizations
Publication Month/Year
January 4, 2017
Last Updated Month/Year
November 25, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes. This guideline, a collaborative effort between the American Thoracic Society and the American College of Chest Physicians, provides evidence-based recommendations to optimize liberation from mechanical ventilation in critically ill adults.
Target Patient Population
Critically ill adults
PICO Questions
Should Acutely Hospitalized Adults Who Have Been Mechanically Ventilated for More Than 24 Hours Be Subjected to Protocolized Rehabilitation Directed toward Early Mobilization or No Protocolized Attempts at Early Mobilization?
Should Acutely Hospitalized Adults Who Have Been Mechanically Ventilated for More Than 24 Hours Be Managed with a Ventilator Liberation Protocol or No Protocol?
Should a Cuff Leak Test Be Performed before Extubation of Mechanically Ventilated Adults?
Should Systemic Steroids Be Administered to Adults Who Fail a Cuff Leak Test before Extubation?
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Hospital, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D012123 - Pulmonary Ventilation
Keywords
mechanical ventilation
Source Citation
Schmidt GA, et al. Official Executive Summary of an American Thoracic Society / American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. Am J Respir Crit Care Med 2017; 195(1):115-119 and CHEST 2017; 151(1):160–165.
Girard TD, et al. Liberation from Mechanical Ventilation in Critically Ill Adults: An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline. Rehabilitation Protocols, Ventilator Liberation Protocols, and Cuff Leak Tests. Am J Respir Crit Care Med 2017; 195(1):120-133.
Ouellette DR, et al. Liberation from Mechanical Ventilation in Critically Ill Adults: An Official American College of Chest Physicians/American Thoracic Society Clinical Practice Guideline. Inspiratory Pressure Augmentation during Spontaneous Breathing Trials, Protocols Minimizing Sedation, and Non-invasive Ventilation Immediately After Extubation. CHEST 2017; 151(1): 166-180.
Supplemental Methodology Resources
Systematic Review Document, Data Supplement, Data Supplement, Data Supplement, Data Supplement