NOCTURNAL MECHANICAL VENTILATION AFTER LO NG-TERM MECHANICAL VENTILATION

Background: Weaning from the mechanical ventilator often proves to be difficult after prolonged ventilation due to excessive load or decreas ed capacity of the respiratory muscles. In the present retrospective s tudy we examined the impact of the nocturnal mechanical ventilation du ring the ''post-weaning-period'' of long-term ventilated patients. Pat ients and Methods: We studied 43 patients (23 men, 59.1 +/- 14.6 years ) with chronic respiratory failure who were transmitted from external ICUs alter a mechanical ventilation period of 57.5 +/- 60.3 days. The weaning regime consisted of an individually adapted volume-cycled vent ilation. Ii the patients were hypercapnic (pCO(2) > 48 mm Hg) alter th e first 24-hour-period of spontaneous breathing without supplemental o xygen nocturnal mechanical ventilation was initiated. Results and Conc lusions: In a retrospective study we could show that the derision to i nitiate invasive or noninvasive nocturnal mechanical ventilation after successful weaning primarily depends on the question whether a chroni c hypercapnic respiratory failure persisted also alter weaning from lo ng-term mechanical ventilation. In about 40%, of unselected patients n octurnal mechanical ventilation stabilized the weaning success whereas 60% of the patients did not need any further nocturnal mechanical ven tilation.