The care of patients who are receiving
artificial mechanical ventilation is complex
and requires skill and experience. This
two-part series outlines some of the
important aspects of one specific part of
this care – the point at which the patient
is removed from the ventilator. This article
focuses on the various physical and
psychological effects that patients may
experience. The second article will focus
on the practical aspects of nursing care
required to prevent complications arising.
Taking a patient off a ventilator is usually
a gradual process, often referred to
as weaning. There are numerous articles
that describe this process in detail, and
clear protocols have been developed
(MacIntyre, 2002).
While a great deal has been written about
how to wean patients off mechanical
ventilation, less has been published about
the care they should receive once they have
been removed. It is important to be aware
that there are both physical and
psychological factors involved when a
patient is taken off a ventilator (Mårtensson
and Fridlund, 2002).
Nurses play an important role in ensuring
that a holistic approach is taken to the care
of patients in this situation.
Physical effects
When patients are receiving mechanical
ventilation all of their body systems will
experience physiological changes that will
be reversed once the ventilation has been
discontinued. These changes mainly affect
the cardiac and respiratory systems but
it is important to consider how other parts of
the body are altered.
Respiratory problems
The respiratory effects of discontinuing
ventilation will depend partly on the initial