Abstract
Long-term mechanical ventilation (MV) increases heath care cost. Difficult-to-wean patients represent a challenge to health care providers and patient's family. Patient with chronic obstructive pulmonary diseases (COPDs) are usually difficult to wean off mechanical ventilators for many pathophysiological reasons. Modes of ventilation used in MV weaning have produced variable results. The main shortcoming of currently available modes of weaning is inability to meet patient's changing ventilator demand. Proportional assist ventilation (PAV) is a new mode of ventilation designed to keep up with patient's breathing demand and unload work of breathing. In this case report, we have shown that PAV was able to wean off a patient with COPD who had been on the ventilator for 37 days.