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Weaning

Overview

Weaning of mechanical ventilator is gradual withdrawal of ventilatory support through utilization of a variety of ventilator modes, periods of total spontaneous ventilation, and appropriate rest periods for muscle unloading. Discontinuation of mechanical ventilation should occur as soon as the patient is able to protect his/her airway and sustain a physiologically-competent minute ventilation while important indicators of disease show resolution

criteria for Spontaneous Breathing Trial (SBT)

• Respiratory Criteria

1. PaO2>= 60 mm hg ( FiO2<40-50,PEEP<5-8cm H2O)
2. PaCo2 normal or base line
3. Pt able to initiate inspiratory effort

• Cardiovascular Criteria

1. No evidence of myocardial ischemia
2. HR<140/min
3. BP normal without vasopressor or minimal vasopressor support
4. Adequate mental status :arousable/GCS.13

• Absence of correctable comorbid conditions

1. Patient is afebrile
2. No significant electrolytes abnormalities

Patient who will tolerate Weaning

the criteria that predict the patient tolerance to weaning are

1. Tidal volume :5-7 ml/Kg
2. respiratory rate is :10-18 per minute
3. total ventilation:5-6 L /min
4. RR/Vt ratio :40-50/L
5. MIP ( maximum inspiration pressure )between 90- to -120 cm H2O