Respiratory muscle failure in critically ill patients

We have presented an approach to the management of ventilator-dependent patients that is based on the current understanding of the role played by the respiratory muscles in the pathophysiology of the respiratory pump failure syndrome. We have refrained from providing strict numerical guidelines for weaning decision-making because the predictive value of most weaning parameters is limited and the rationale for predicting weaning outcome is weak. The many gaps in knowledge must stimulate us to seek answers by defining cardiorespiratory system function prior to weaning, by relating certain types of impairment to certain weaning response patterns, and by improving our diagnostic capabilities of respiratory muscle contractile state.