High complexity rehabilitation in prolonged weaning patient: Role of pneumologist An Experts' Panel Position Paper

Aim of this position paper is to recognize scientific specificity of patients under prolonged weaning from mechanical ventilation, to enhance the expertise of the respiratory physician in this field, to propose criteria of appropriateness and to discuss educational, organizational and technological standards of high complexity rehabilitation to offer to these patients. The document takes into account the definition of a patient with prolonged weaning; it analyzes the extent of the problem from the epidemiological point of view, the pathophysiological causes leading to this condition, the clinical and psychological consequences related to the quality of life and the social and health costs; finally, it also stresses the programs and methods of treatment, summarizes the main findings of the literature showing a photograph of the state of the art in Italy. There is already an important international consensus of the specific issues related to those patients under prolonged weaning. The creation of an italian network of specialized centers dedicated to "highly complex" rehabilitation may be the best cost/benefit answer to the dramatic economical impact that this population has on the Regional Health System.