• Vasilios Papaioannou, Christos Dragoumanis, and Ioannis Pneumatikos.
• Department of Intensive Care Medicine, Democritus University of Thrace, Alexandroupolis Medical School, 68100 Dragana, Greece. papabil69@vodafone.net.gr
• J Crit Care. 2010 Mar 1; 25 (1): 39-46.

AbstractDiscontinuation of mechanical ventilation in critically ill patients is a challenging task and involves a careful weighting of the benefits of early extubation and the risks of premature spontaneous breathing trial. Recently, apart from studying different physiological variables by means of descriptive statistical tests, breathing pattern variability analysis has been performed for the assessment of weaning readiness. A limited number of clinical studies implementing different weaning protocols in heterogeneous groups of patients and using a variable set of signal processing techniques have appeared in the critical care literature, with varying results. The purpose of this review article is 3-fold: (1) to describe the different signal processing techniques being implemented for the assessment of weaning readiness, (2) to provide insight into the pathophysiological mechanisms that may govern breath-to-breath variability/complexity in health and disease, and (3) to present results from the critical care literature derived from the application of biosignal analysis tools for the identification of possible weaning indices.Copyright 2010 Elsevier Inc. All rights reserved.

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