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What Causes Difficulty In Weanin Off Ventilator?

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Posted on Thu, 29 May 2014
Question: My mother who is 78 years of age is currently on a ventilator and having a difficult time being weened off of it. My mom has CLL and was being treated rather successfully for Lung Cancer which was in her left lung. Unfortunately the CLL and Alimta that was being used to treat her lung cancer lowered her immunoglobulin levels and caused her a pneumonia to develop in her right lung that was so severe that she was in the Intensive Care Unit of our local hospital for nearly 6 weeks. I was hopefully that after two Bronchs, the origin of the pneumonia would be discovered and there would be a specific treatment protocol for her recovery but this was not the case. She has been on a ventilator for two months. Had a trache about 6 weeks ago and is not managing to be weened from the ventilator. I have been told her tidal volume is low and that her chances of being weened are not good. Bottom line is that she would very much like to return to home--she has lived with me for the last several years and I want to honor her request. I am able to take leave time from work and be with her as much as I need to be. Although, I am certainly open to get as much help for her care as I can afford. To make a long story longer, although rare maybe, I have been told that some people manage to eat and drink while on a vent. I know that my mom can hold her sat for a good while and I have every reason to believe that she can effectively swallow. The speech teacher at the hospital we were at and at the last sub acute care facility would not even consider doing a swallow test until my mother was weened or on the verge of being weened. My question, why can't the speech pathologist just shut up and give it a try? I just really want my mom to be able to eat and/or drink something if in fact she is destined to be on a vent for the rest of her days.
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Answered by Dr. Ram Choudhary (5 hours later)
Brief Answer:
Homecare worthwhile

Detailed Answer:
Hi XXXX
Welcome to healthcare Magic!
I have gone through the history treatment and problem details of your mother's illness.
Your patient is having too many critical issues- CLL Immunocompromised state and pneumonia.
These elderly patients most often have a prolonged suffering and ultimately most of them succumb to the complications like infections, venous thromboembolism and prolonged bed ridden state.
Your mother is on tracheotomy for 6weeks and still not weaned indicates the things towards adverse side and I fully agree with you about home care as this is the patient's wish and we are unsure of the ultimate outcome.
You need to arrange a home care setup for proper care.
After prolonged illness patients have impairment of swallowing for long time. She should be fed orally only if a critical care physician is convinced about her swallowing.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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What Causes Difficulty In Weanin Off Ventilator?

Brief Answer: Homecare worthwhile Detailed Answer: Hi XXXX Welcome to healthcare Magic! I have gone through the history treatment and problem details of your mother's illness. Your patient is having too many critical issues- CLL Immunocompromised state and pneumonia. These elderly patients most often have a prolonged suffering and ultimately most of them succumb to the complications like infections, venous thromboembolism and prolonged bed ridden state. Your mother is on tracheotomy for 6weeks and still not weaned indicates the things towards adverse side and I fully agree with you about home care as this is the patient's wish and we are unsure of the ultimate outcome. You need to arrange a home care setup for proper care. After prolonged illness patients have impairment of swallowing for long time. She should be fed orally only if a critical care physician is convinced about her swallowing. I hope the advise would be informative and useful for you. Take Care!