Identifying determinants of repeated ventilator weaning failure offers opportunities for clinicians to recognize interventions that may prevent this phenomenon and expedite independence from mechanical ventilation. Chen and colleagues tested an explanatory psychophysiological ventilator weaning model to identify psychological and physiological factors that may predict repeated weaning failure. They found the following:
Both psychological and physiological factors are important determinants of repeated ventilator weaning failure.
An unsuccessful ventilator weaning trial can breed patient fear. This can cause high anxiety that compromises respiratory function and causes future weaning attempts to fail.
Even a single ventilator weaning failure can initiate a stimulus-response (think Pavlov’s dogs) of fear and high anxiety that fosters repeated weaning failures and prolonged mechanical ventilation.
Managing a patient’s fear and anxiety after a single weaning failure is critical to improve future ventilator weaning success.
—Karen McQuillan,rn, ms, cns-bc, ccrn, cnrn