【呼吸科】2016+ATS／ACCP临床实践指南：危重症患者机械通气撤机.pdf

AMERICAN THORACIC SOCIETY DOCUMENT An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. Rehabilitation Protocols, Ventilator Liberation Protocols, and Cuff Leak Tests Timothy D. Girard, Waleed Alhazzani, John P. Kress, Daniel R. Ouellette, Gregory A. Schmidt, Jonathon D. Truwit, Suzanne M. Burns, Scott Epstein, Andres Esteban, Eddy Fan, Miguel Ferrer, Gilles L. Fraser, Michelle Ng Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy Pawlik, Curtis N. Sessler, Thomas Strom, William Schweickert, Kevin C. Wilson, and Peter E. Morris THIS OFFICIAL CLINICAL PRACTICE GUIDELINE OF THE AMERICAN THORACIC SOCIETY (ATS) AND THE AMERICAN COLLEGE OF CHEST PHYSICIANS (CHEST) WAS APPROVED BY THE ATS BOARD OF DIRECTORS AND BY THE CHEST BOARD OF R EGENTS This article is one component of the official ATS/CHEST clinical practice guideline; it is being simultaneously published in the American Journal of Respiratory and Critical Care Medicine and in Chest. Recommendations 1-3 in detail are being published as a separate article in CHEST. Correspondence and requests for reprints should be addressed to Timothy D. Girard, M.D., M.S.CI., University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15261. E-mail: timothy.girard@upmc.edu. Page 1 of 45 AJRCCM Articles in Press. Published on as 10.1164/rccm.201610-2075ST Copyright © by the American Thoracic Society Page 1 of 45 AJRCCM Articles in Press. Published on 20-October-2016 as 10.1164/rccm.201610-2075ST Copyright © 2016 by the American Thoracic Society ABSTRACT Background: Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes. This guideline, a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST), provides evidence-based recommendations to optimiz