Mechanical ventilation is a common supportive therapy in children admitted to PICUs. As the patient improves, the focus should shift to weaning from IMV, which requires careful assessment to avoid extubation failure (EF). Variability in practices across institutions and practitioners, due to the lack of specific weaning protocols, contributes to EF. Recently, the first international guidelines on pediatric ventilation liberation were published, offering 15 recommendations for patients requiring >24 hours of IMV.