Weaning mechanical ventilation

Weaning Paramater

1. PaO2/FiO2 >200
2. Tidal volume 5cc/kg
3. RR <20
4. Vital cap 10cc/kg
5. Min vent. <10L/min
6. FiO2 < 0.4 with pO2 > 60 and PEEP < 8
7. SBP > 90 without pressors

Greater Predictive Value

1. Max inspir. pressure greater -90cmH2O female, -120cmH2O male, weaning threshold -25 cm h2o
2. 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 abnl, Eating (nutrition)
  • Anti-inflammatories (steroids in asthma/COPD)
  • Neuromuscular disease, Neuro status compromised

See Also

• Ventilation (Main)
• Ventilation (Settings)
• Ventilation (Non-Invasive)
• Ventilation (Strategies)