The Utility of Osteopathic Manipulative Medicine in Weaning Patients from the Ventilator Pilot Trial

Inclusion criteria

• Acute respiratory failure (hypoxic, hypercapnic, or neuromuscular)
• Not making satisfactory progress with weaning after being on the ventilator for more than 48 hours
• Clinical stability for pressure support trial with ventilator to monitor ventilation progression
• Pulmonology must be following the patient for standardized ventilator management approach and interventions as needed
• Medical power of attorney (POA) or legally authorized representative (LAR) who is able to consent subject for trial enrollment and treatment
• Patients who were not referred to the OMM service

Exclusion criteria

• Age less than 18 years old or more than 85 years old
• BMI>60
• Moderate/severe neurological disease with expectation of non-progression off the ventilator or poor quality of life predicted (including end-stage dementia with the expectation of non-progression off ventilator, multiple sclerosis, ALS, anoxic brain injury, etc)
• Status epilepticus or EEG result pending
• Post-arrest hypothermia protocol
• Acute stroke
• Acute rib fractures preventing the implementation of the treatment protocol
• Acute spinal injury preventing the implementation of the treatment protocol
• Recent head injury requiring close clinical monitoring
• Ejection Fraction less than 15%
• Pleural effusion requiring procedural intervention or inhibiting ventilator progress
• Pericardial effusion or tamponade requiring procedural intervention or inhibiting ventilator progress
• ACLS/cardiac arrest within the past 72 hours
• Confirmed opioid overdose with positive urine drug screen and response to naloxone
• Patients who were referred to the OMM service