Weaning mechanical ventilation

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

• 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

• Noninvasive ventilation
• Intubation
  • Intubation (peds)
• Mechanical ventilation (main)
  • Ventilation modes
  • Initial mechanical ventilation settings
    • Initial mechanical ventilation settings (peds)
  • Adjusting mechanical ventilation settings
    • Deterioration after intubation
    • Lung recruitment maneuver
    • Ventilator high pressures
    • Ventilator associated lung injury
  • Weaning mechanical ventilation
    • Extubation
• Miscellaneous
  • ARDS and EBQ:ARDSnet
  • Airway pressure release ventilation
  • Ideal Body Weight Estimation