Speeding the Weaning up: Aggressive Screening Criteria and Higher Minimal Ventilatory Settings.

Launched by GONZALO HERNANDEZ MARTINEZ · Feb 16, 2021

Keywords

ClinConnect Summary

Discontinuation of mechanical ventilation is a three-step process including:

1. - Readiness testing.

It evaluates the criteria to determine whether a patient might be able to be successfully and safety weaned from mechanical ventilation. The detection of readiness to try a spontaneous breathing test has controversial questions, in special concerning to oxygenation. From a conservative to an aggressive criteria we can list:
1. PaO2/FiO2 \> 200 on PEEP ≤ 5 cm H2O (Esteban et al, 1999).
2. PaO2/FiO2 ≥ 150 on PEEP ≤ 8 cm H2O (Boles et al, 2007).
3. PaO2/FiO2 \> 180 on PEEP ≤ 10 cm...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients on mechanical ventilation for more than 24 hours with \>= positive end-expiratory pressure 10.
• • Patients with up to three high risk factors for extubation failure excluding hypercapnia during the spontaneous breathing trial and obese patients (BMI \>30).
• • Patients fulfilling weaning criteria expected to have a spontaneous breathing trial in the following 24 hours.
• • Patients expected to be prevented with high-flow oxygen therapy after extubation.
• Exclusion Criteria:
• • \<18 years old.
• • Pregnant women.
• • Tracheostomized patients.
• • Accidental or self-extubated patients.
• • Obese (BMI \>30) or hypercapnic patients during the spontaneous breathing trial.