Prolonged Weaning and Respiratory Intensive Care Units. A Narrative Review

Abstract

Progress in management, while improving hospital survival of critically ill individuals in intensive care units (ICU), has also increased the prevalence of individuals needing prolonged weaning from mechanical ventilation (PMV). Respiratory intensive care units (RICUs) may provide an environment also for these individuals. A narrative review searching literature was performed in PubMed and Scopus databases of publications between 1990 and 2022 using the keywords “chronic critical illness”, “non-invasive mechanical ventilation”, “physiotherapy and ICU”, “RICU”, “tracheostomy”, “ventilator assisted individuals”, “weaning mechanical ventilation”. Results show that there are recent developments in ventilatory strategies, protocols, physiotherapy, and location for individuals needing PMV to be managed also in RICU. In conclusion, present medical training of clinicians and locations like ICU do not appear to be enough to face problems posed by PMV. RICU may be helpful.

Keywords

• Critical illness. Intensive care unit. Mobilisation. Noninvasive ventilation. Tracheostomy. Weaning units.