Weaning from Mechanical Ventilation

These flashcards cover key concepts related to weaning from mechanical ventilation as discussed in the lecture.

What is the primary indication for considering weaning from mechanical ventilation?

Weaning should be considered as soon as the patient is placed on the ventilator and when the problem that necessitated ventilation is resolved.

What are the maximum inspiratory pressure (MIP) criteria for weaning?

MIP should be at least 20 cmH2O.

What tidal volume (TV) is considered for weaning?

Tidal volume should be greater than 5 mL/kg or > 250 mL.

Define the Rapid Shallow Breathing Index (RSBI) and its acceptable value for weaning.

RSBI is the respiratory rate (f) divided by the tidal volume (VT in Liters) and should be < 100.

What is the significance of a PaO2/FiO2 ratio in weaning criteria?

A PaO2/FiO2 ratio greater than 200 indicates sufficient oxygenation for potential weaning.

What is the duration of the spontaneous breathing trial (SBT)?

The minimum trial duration is 30 minutes and the maximum is 2 hours.

What should be done if the spontaneous breathing trial fails?

The patient should be placed back on the ventilator at full settings and rested overnight before retrying the next day.

List three weaning methods used to support spontaneous breathing.

1. Reducing the SIMV rate for more spontaneous breathing. 2. CPAP + PSV for aiding spontaneous tidal volume. 3. T-piece for removing the ventilator while providing oxygen.

What should be monitored during a spontaneous breathing trial?

Respiratory rate, heart rate, blood pressure, patient’s anxiety or agitation, oxygen saturation (SpO2), and pH.

Name two categories of medications that should be discontinued before initiating a spontaneous breathing trial.

Narcotics and neuromuscular blocking agents.