Kenneth Nugent MD

40%, PEEPimage 5

  • Primary indication for mechanical ventilation improving
  • Adequate Hb (image 10 g/dL), adequate Kimage 3.5 mEq/L

      Discontinue sedation


       


      • Plan sedation management during the prior hospital day

      Start spontaneous breathing trial (SBT)


       


      • Usually CPAP (5cm H2O) + pressure support (5 cm H2O)
      • Monitor clinical status, RR, HR, BP, sats for 30–120 minutes
      • There is no benefit leaving a patient on a SBT longer than 120 minutes

      Check weaning parameters at end of trial (bedside measurements by RT)


       


      • RSBI (rapid shallow breathing index) 105 breaths/liter

             image   Dividing the RR by the spontaneous VTE



      • Negative inspiratory force (NIF) more negative than – 20 cm H2O
      • Forced vital capacity (FVC) image 10 ml/kg IBW.

      Check cuff leak (bedside measurements by RT)


       

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      Jan 28, 2017 | Posted by in CARDIOLOGY | Comments Off on Kenneth Nugent MD

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