In mechanically ventilated patients with cardiac disease, withdrawal of ventilatory support is associated with hemodynamic changes which impair cardiac function and may in turn lead to a failure of the spontaneous breathing trial. Occult cardiac disease is a common and under appreciated cause of failure to “wean.” I have dealt with this issue in a previous post.
Now an excellent update on the topic is available as open access full text in Critical Care. It's the best discussion I've found yet on this topic.
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