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Editorials |

Weaning the Difficult Patient : The Evolution From Art to Science

Yizhak Kupfer, MD, FCCP; Sidney Tessler, MD, FCCP
Author and Funding Information

Affiliations: Brooklyn, NY 
 ,  Dr. Kupfer is Assistant Professor of Medicine, SUNY at Brooklyn and Associate Director, Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center; Dr. Tessler is Associate Professor of Clinical Medicine, SUNY at Brooklyn and Director, Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center.

Correspondence to: Sidney Tessler, MD, FCCP, Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center, 4802 Tenth Ave, Brooklyn, NY 11219; e-mail: stessler@maimonidesmed.org



Chest. 2001;119(1):7-9. doi:10.1378/chest.119.1.7
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Weaning patients from mechanical ventilatory support remains a significant challenge. Determining the optimal time and mode of weaning has been described as “an arbitrary clinical decision based on judgment and experience.”1 The fact that 50% of self-extubated patients do not require reintubation suggests that our judgment and experience are far from complete.23 The difficulty we still have in discontinuing mechanical ventilatory support is evidenced by the fact that 40% of the time that a patient spends receiving mechanical ventilation is devoted to weaning.4 Research performed in the last decade has yielded vital information that is making weaning more of a science and less of an art.

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