الفهرس 
Overview on Respiratory FailureOnly 14 pages are availabe for public view
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Abstract
Patients with respiratory failure frequently require endotracheal intubation (ETI) and mechanical ventilation (MV) to sustain life. While invasive ventilation is effective, it has been associated with the development of complications including respiratory muscle weakness, upper airway pathology, ventilator associated pneumonia (VAP) and sinusitis [1].VAP is in turn associated with increased morbidity and a trend toward increased mortality. For these reasons, minimizing the duration of invasive mechanical support is an important goal of critical care medicine [2]. Removal of patients from mechanical ventilation (MV) has been termed liberation, discontinuation, withdrawal and most commonly weaning. The process of permanent removal of the artificial airway is extubation [3].
A balance must be achieved between the risk associated with early discontinuation and delay in extubation. Premature withdrawal causes loss of airway protection, cardiovascular stress, suboptimal gas exchange, muscle overload and fatigue. Delayed withdrawal exposes to complications associated with ventilation like infections, barotrauma, stretch injury, sedation, airway trauma and costs [4].Non-invasive ventilation (NIV) can be used to facilitate weaning (earlier extubation), to prevent re-intubation in post-surgical respiratory distress, and in patients with respiratory failure after planned extubation. In the latter instance NIV has been used immediately after extubation in patients at elevated risk for extubation failure [5]. On the other hand, NIV has been applied in patients who developed overt respiratory failure after extubation, with the goal of avoiding re-intubation [6].