[Weaning: more than terminating mechanical ventilation]

Mechanical ventilation is an essential part of modern intensive care. It is used in patients with acute respiratory failure and, depending on the type of respiratory failure, different modes of application. In particular, invasive mechanical ventilation should be terminated as raidly as possible to avoid the associated risks.The major proportion of ventilated patients can be weaned from mechanical ventilation without problems after a short treatment period. In about 20% of ventilated patients, however, an extremely protracted and complex weaning process can be observed, even though the cause necessitating ventilation has long since been eliminated. In addition to the stages in the process of weaning from the ventilator, in particular the pathophysiological processes that lead to prolonged weaning are addressed in this article.