Ventilation weaning

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Weaning Paramater

  • PaO2/FiO2 >200
  • Tidal volume 5cc/kg
  • RR <20
  • Vital capacity 10cc/kg
  • Minute ventilation. <10L/min
  • FiO2 < 0.4 with pO2 > 60 and PEEP < 8
  • SBP > 90 without pressors

Greater Predictive Value

  • Max inspiratory pressure greater -90cmH2O female, -120cmH2O male, weaning threshold -25 cm h2o
  • RSBI: rate/tidal volume < 100 min/L.

Failure to Wean

FAIL TO WEAN [1]

  • Fluid overload
  • Airway resistance (small ETT, mucous plug, etc.)
  • Infection
  • Lying down (elevate HOB)
  • Thyroid, Toxicity (meds)
  • Oxygenation insufficient
  • Wheezing (nebs for asthma/COPD)
  • Electrolyte abnormality (including Mg/Phos), Eating (nutrition)
  • Anti-inflammatories (steroids in asthma/COPD)
  • Neuromuscular disease, Neuro status compromised

See Also

Mechanical Ventilation Pages

References

  1. UIC ICU Guidebook. Mechanical Ventilation - Weaning/Extubation. 2013. http://chicago.medicine.uic.edu/UserFiles/Servers/Server_442934/Image/1.1/residentguides/final/icuguidebook.pdf