The number of patients requiring prolonged mechanical ventilation (PMV) is growing and will likely continue to grow significantly into the near future.1 PMV has no universally agreed upon definition, but it is most frequently described as the need for mechanical ventilation for > 14–21 d.2,3 Whereas patients requiring PMV represent only about 5% ICU admissions, they account for a disproportionate number of total ICU days.3 Consequently, they incur high health care costs, put a significant strain on ICU staffing, and have a high mortality, with > 50% not surviving 1 year from ICU discharge.2,4 Understanding outcomes and best care models for patients who require PMV is critically important.
Specialized weaning centers (SWCs) have been developed with the goal of optimizing care in a multidisciplinary manner to improve overall outcomes in patients with chronic critical illness requiring PMV. These centers or units may be known as specialized weaning centers, long-term acute care hospitals, critical illness recovery hospitals, or prolonged ventilation weaning centers depending on the country in which they are located. In general, these centers provide value by achieving at least one of the following outcomes relative to continued care in the ICU: similar clinical outcomes at a lower cost or better clinical outcomes at a similar cost. The COVID-19 pandemic has highlighted another …
Correspondence: Craig R Rackley MD, Division of Pulmonary, Allergy, and Critical Care Medicine, Box 102355, Duke University Medical Center, Durham, NC 27710. E-mail: craig.rackley{at}duke.edu
