Weaning mechanical ventilation: Difference between revisions
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==Weaning Paramater== | ==Weaning Paramater== | ||
* PaO2/FiO2 >200 | *PaO2/FiO2 >200 | ||
* Tidal volume 5cc/kg | *Tidal volume 5cc/kg | ||
* RR <20 | *RR <20 | ||
* Vital | *Vital capacity 10cc/kg | ||
* | *Minute ventilation. <10L/min | ||
* FiO2 < 0.4 with pO2 > 60 and PEEP < 8 | *FiO2 < 0.4 with pO2 > 60 and PEEP < 8 | ||
* SBP > 90 without pressors | *SBP > 90 without pressors | ||
==Greater Predictive Value== | ==Greater Predictive Value== | ||
*Max | *Max inspiratory pressure greater -90cmH2O female, -120cmH2O male, weaning threshold -25 cm h2o | ||
*RSBI: rate/tidal volume < 100 min/L. | *RSBI: rate/tidal volume < 100 min/L. | ||
==Failure to Wean== | ==Failure to Wean== | ||
'''FAIL TO WEAN <ref>UIC ICU Guidebook. Mechanical Ventilation - Weaning/Extubation. 2013. http://chicago.medicine.uic.edu/UserFiles/Servers/Server_442934/Image/1.1/residentguides/final/icuguidebook.pdf</ref>''' | '''FAIL TO WEAN <ref>UIC ICU Guidebook. Mechanical Ventilation - Weaning/Extubation. 2013. http://chicago.medicine.uic.edu/UserFiles/Servers/Server_442934/Image/1.1/residentguides/final/icuguidebook.pdf</ref>''' | ||
*'''F'''luid overload | *[[fluid overload|'''F'''luid overload]] | ||
*'''A'''irway resistance (small ETT, mucous plug, etc.) | *'''A'''irway resistance (small ETT, mucous plug, etc.) | ||
*'''I'''nfection | *[[infection|'''I'''nfection]] | ||
*'''L'''ying down (elevate HOB) | *'''L'''ying down (elevate HOB) | ||
*'''T'''hyroid, | *[[thyroid|'''T'''hyroid]], [[toxicology (main)|'''T'''oxicity]] (meds) | ||
*'''O'''xygenation insufficient | *[[hypoxia|'''O'''xygenation]] insufficient | ||
*'''W'''heezing (nebs for [[asthma]]/[[COPD]]) | *[[wheezing|'''W'''heezing]] (nebs for [[asthma]]/[[COPD]]) | ||
*'''E'''lectrolyte | *[[electrolyte abnormality|'''E'''lectrolyte abnormality]] (including Mg/Phos), '''E'''ating (nutrition) | ||
*'''A'''nti-inflammatories (steroids in [[asthma]]/[[COPD]]) | *'''A'''nti-inflammatories ([[steroids]] in [[asthma]]/[[COPD]]) | ||
*'''N'''euromuscular disease, Neuro status compromised | *'''N'''euromuscular disease, Neuro status compromised | ||
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[[Category:Critical Care]] | [[Category:Critical Care]] | ||
[[Category: | [[Category:Pulmonary]] | ||
Latest revision as of 16:08, 27 September 2019
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
- Noninvasive ventilation
- Intubation
- Mechanical ventilation (main)
- Miscellaneous
References
- ↑ UIC ICU Guidebook. Mechanical Ventilation - Weaning/Extubation. 2013. http://chicago.medicine.uic.edu/UserFiles/Servers/Server_442934/Image/1.1/residentguides/final/icuguidebook.pdf