Figure 1

The seven stages of weaning. Stage 1 is pre-weaning, a stage that many patients never move beyond. Stage 2 is the period of diagnostic triggering, the time when a physician begins to think that their patient might be ready to come off the ventilator. Stage 3 is the time of measuring and interpreting weaning predictors. Stage 4 is the time of decreasing ventilator support (abruptly or gradually). Stage 5 is either extubation (of a weaning-success patient) or when mechanical ventilation is reinstated (in a weaning-failure patient). Stage 6 is the use of noninvasive ventilation (NIV) after extubation. Stage 7 is reintubation. Failure to appreciate stage 2 probably leads to the greatest delay in weaning. Reproduced from [2] with permission from the publisher.