Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Liberation from Mechanical Ventilation in Critically Ill Patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines

  • Tae Sun Ha (Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Dong Kyu Oh (Department of Pulmonology, Dongkang Medical Center) ;
  • Hak-Jae Lee (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Youjin Chang (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • In Seok Jeong (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital) ;
  • Yun Su Sim (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital) ;
  • Suk-Kyung Hong (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sunghoon Park (Lung Research Institute of Hallym University College of Medicine) ;
  • Gee Young Suh (Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • So Young Park (Lung Research Institute of Hallym University College of Medicine)
  • Received : 2024.03.21
  • Accepted : 2024.06.25
  • Published : 2024.10.31
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Abstract

Background: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care, because it is the first step through which a respiratory failure patient begins to transition out of the intensive care unit, and return to normal life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider scientific and systematic approaches, as well as the individual experiences of healthcare professionals. Recently, numerous studies have investigated methods and tools to identify when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians for liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. These evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved the recommendations. Results: Recommendations for nine questions on ventilator liberation about Population, Intervention, Comparator, and Outcome (PICO) are presented in this document. This guideline presents seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusion: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Keywords

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