WEANING/LONG TERM VENTILATOR UNITS

As Simonds points out in an accompanying editorial to the paper by Pilcher and colleagues in this month’s Thorax, around 3–6% of patients admitted to the intensive care unit (ICU) require a prolonged course of mechanical ventilation and 2.5% of ICU admissions are weaning failures. In the USA, Simonds writes that there are 11 000 ventilator dependent patients in acute care facilities costing over $9 million a day. The outcome of weaning units is therefore an important topic, and Pilcher and colleagues describe the results of a 4 year follow up study from a regional weaning unit in South London, UK. They found that 38% of patients admitted to the unit were fully weaned, 27% died, and 35% required ventilatory support at discharge from hospital. Overall survival at 3 years from admission was 47%; patients with neuromuscular and chest wall conditions had the best …