Norman Jay T.

ALmeana
Post graduate Intern
IDH- IM
Criteria for Removal of Mechanical Ventilator Support
1. Upper Airway function must be intact for a patient to remain
extubated
2. Rapid shallow breathing index, which is the ratio of the breathing
frequency to tidal volume should ideally be <105
3. Alveolar Ventilation is deemed adequate such that:
a. Elimination of CO2 is sufficient to maintain arterial pH 7.357.40
b. SaO2 >90% can be achieved with an FiO2 <0.5 and PEEP
<5 cm H20
Conditions to be met for Weaning Patients from Mechanical Ventilation
1. Stable cardiovascular status
2. Resolution or improvement of the cause of respiratory failure
3. Adequate gas exchange
4. Adequate respiratory pump capacity
5. Cessation of sedative drugs
6. Cessation of neuromuscular blocking agents
7. Absence of sepsis or marked fever
8. Correction of metabolic disorders
9. No planned general anesthesia
How to Determine if Weaning has Failed?
Weaning failure is defines as either the failure of Spontaneous
Breathing Trial(SBT), or the need for reintubation witin 48 hours
following extubation
SBT is declared a failure if:
1. RR> 35/min for > 5 mins
2. O2 Saturation <90%
3. HR> 140/min or a 20% increase or decrease from baseline
4. Systolic BP <90 mmHg or >180 mmHg
5. Increased anxiety or diaphoresis