These are difficult decisions to make, and
one of the main adverse consequences of
removing patients from mechanical
ventilation is that they are unable to breathe
independently. This may be due to the
recurrence of the original medical condition
or as a consequence of their medical
treatment (Adam and Osborne, 2005).
Patients who have been receiving
ventilation for a long period will have
undergone changes in their respiratory
physiology that will be reversed when this
therapy is discontinued. While they are on
the ventilator the respiratory muscles have
to do very little work. Once artificial
ventilation is stopped these muscles have to
take over the full work of breathing. This
extra effort can often make the patients feel
weak and exhausted (Mårtensson and
Fridlund, 2002).