TABLE 4.

Transition from prolonged mechanical ventilation (MV) or long-term MV (LTMV) to acute critical care ventilation (reverse transition)

Criteria that should define transition	%
Acute loss of physiological stability	95
The patient’s and family’s wishes for full intervention for reversible condition	95
Need for escalating medical/health care that cannot be provided in current environment	95
Patient’s wishes based on informed choice (ie, right to decline)	92
Availability of resources outside of intensive care unit to manage LTMV (ie, patients should not be admitted to an intensive care unit solely because ventilated	92
Existing plan of care/advanced directives agreed by patient, family and health care team	87
Nonacute/progressive deterioration of medical condition warranting acute critical care	85
Planned admission for redefining care plan	80
Withdrawal of life support when resources to do so are not available in the patient’s community	77
Community placement availability (ie, need to return to an acute care institution due to unavailability of community placement	71
Criteria that should NOT define transition
Patient demographic characteristics	84
Minimum number of consecutive days/hours on MV	87
Gradual, expected increase in ventilator demands/progression of underlying condition	74