Objective To sum up nursing strategy and reasons of ventilator weaning failure in sober patients of intensive care unit (ICU) with long - term use ventilator. Methods Using acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ) to assess severity of disease, the reasons of ventilator weaning failure were define by univariate chi -square test and logistic regression analysis and given the right ruidance and care. Results It shows that 40 cases were quite successful, only 5 cases failed. Conclusion Choosing the right approach, tharoughly understanding the psychological state of patients and their needs and giving appropriate psychological counseling, and keeping the airway patency and choosing a suitble time for weaning training.