Psychological dependence on mechanical ventilation, and the resultant fear of being weaned from the ventilator, can be especially severe in patients with chronic obstructive pulmonary disease; this is probably because such patients are all too familiar with the terrors of dyspnea and because they often know their disease is permanent and life-shortening. We have resolved this fear of weaning in some patients by employing a variant of intermittent mandatory ventilation that employs two hyperinflating mechanical sighs every four minutes.
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References
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DownsJB, KleinEF, DesautelsD, ModellJH, KirbyRR: Intermittent mandatory ventilation: a new approach to weaning patients from mechanical ventilation. Chest64:331, 1973.