Airway resistance has been found to be significantly greater in patients who failed weaning trial as compared to successful trial in same patients. Expiratory flow limitation along with high respiratory drive can lead to respiratory muscle fatigue, which is a contributing factor for prolonged
ventilation. Cornerstone in the management of ventilated COPD patients is to reduce bronchoconstriction using bronchodilators and anti‑inflammatory drugs. Guidelines have been published for optimizing delivery of inhaled medications in ventilated patients