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Ventilator weaning ¡ª or as we call it, vent liberation ¡ª is critical to a patient¡¯s recovery and quality of life. Our renowned experts at Shirley Ryan ±©×ߺÚÁÏ have developed a novel process for weaning qualified patients from a ventilator.

Specifically, we provide vent liberation for adults after a spinal cord injury (SCI), as well as for pediatric patients with SCI, brain injuries and other neurological conditions such as Guillain-Barr¨¦ syndrome and transverse myelitis.

Our vent-liberation program is a specialty in and of itself. Your collaborative, interdisciplinary care team has decades of experience helping adult and pediatric patients breathe independently (completely, or in longer intervals). Here¡¯s what sets us apart:

An Early, Proactive Start

Our approach to vent liberation maximizes recovery because it enables you to be more active at our inpatient rehabilitation hospital during the early, critical healing window.

Using targeted-muscle training, we focus on strengthening all functioning muscles used for breathing. We combine strength building with therapies to help teach you how to

breathe differently. We help you increase the efficiency ¡ª and decrease the work ¡ª of breathing. Also, your vent-weaning respiratory therapy is combined with three hours of rehabilitation every day (speech, physical and/or occupational).

Focus on Gains

We take every minute off the vent as a gain. Our goal is to facilitate complete independence, but, in cases where achieving that level is not possible, we aim to help you achieve valuable increments of vent-free breathing so you can live more independently and rely on fewer people to help you with daily tasks.

At every step of the way, we teach you and your family about the process. We train you to breathe differently, and we are here to answer your questions along the way.

Interdisciplinary Team

We take an interdisciplinary approach to vent liberation and assemble the best team ¡ª of therapists, physicians and nurses ¡ª for your specific needs, bringing in additional experts as needed.

Research-based Evaluation

When you arrive, we micro-analyze the function of your respiratory muscles. We evaluate how strong or weak these muscles are using various methods of examining respiratory muscle function ¡ª such as inspiratory excursion measurements; traditional respirator measures; and, notably, a powerful and sophisticated imaging tool called diaphragm ultrasound.

Diaphragm ultrasound allows us to better assess the function of breathing muscles for patients admitted on ventilator support ¡ª and to tailor care and interventions to help each individual achieve their best outcome. Further, with the vast amount of ultrasound data we have collected from this unique population of patients through our research, we are better able to predict overall ventilator weaning success.

Developing strong, independent breathing is an important part of our overall rehabilitation process and looks different than the ventilator-weaning protocols commonly used in other facilities. Our unique process includes:

Arrival & Initial Transitioning

You may transfer to Shirley Ryan ±©×ߺÚÁÏ on full ventilator support. We will monitor you for the first 48 hours to ensure you are stable. This protocol may apply even if you have been participating in ventilator weaning sessions prior to transfer. After the initial monitoring period and if medical indicated, we can start weaning you off the vent.

Trach-collar Trials

At your acute-care hospital, you may have been participating in a process of slowly reducing support from the ventilator. This approach is often called ¡°CPAP¡± or ¡°pressure support¡± trialing. This style of weaning is designed for patients with underlying lung injury or disease (for example, severe pneumonia, lung-scarring, severe COPD). However, at Shirley Ryan ±©×ߺÚÁÏ, we work on strengthening the functioning breathing muscles by removing the vent at intervals and allowing for spontaneous breathing in a safe, monitored environment. This approach is a different version of the pass/fail trach-collar trialing,¡± which is used at some acute-care hospitals.

Airway Clearance

Our respiratory therapists and/or speech therapists will add therapies to help open your airways and clear secretions. Your therapists will use devices and/or expiratory muscle-strength trainers to help strengthen your cough, clear your airways and reduce your risk of developing pneumonia.

Positioning

Our physical therapists and wheelchair seating specialists will get you out of bed, support your core body and work on helping you mobilize your chest wall. This positioning optimizes your ability to breathe independently and will help you start breathing more easily.

Alternatives

For those patients whose conditions make full independent breathing impossible, we evaluate you for use of alternative therapies such as diaphragmatic pacers or noninvasive ventilation.