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Weaning from Mechanical Ventilation - Coggle Diagram
Weaning from Mechanical Ventilation
Complications
Respiratory
Increased work
Increased resistance
bronchospasm
Secretions
Reduced compliance
pnumonia
Oedema
Pnumothorax
Increased requirement
shock
Cardiac
IHD
Valvular disease
Systolic or diastolic dysfunction
CNS
Depressed central drive
Sedation
Alkalosis
Loss of hypoxic drive
Neuromuscular pathology
Primary
GBS
Myasthenia
Botulism
Critical care induced polyneuropathy
Electrolyte
GI
Anaemia
Malnutrition
Obestiy
Reduced FRC
Reduced compliance
Assessment
Clinical
Resolution of underlying cause
Low secretion load
Adequate cough
Cooperative
Objective
Haemodynamically stable
Pa/Fi02 >200
Fi02<0.5
PEEP <10
Predicting success
RSBI =RR/Vt
<65 - likely to be successful
65-105 - maybe successful
105 - likely to fail
Airway occlusion pressure
).1second
5cmH20
Maximal inspiratory pressure <20cmH20
SBT
T peice
30 minutes
Definition of failure of SBT
RR>35
Spo2 <90%
HR >140 or >20%
SBP >180
Mangement
Traceostomy
Reduction in sedation
Trachel toilet
Reduced dead space
Improved communication
A-F
Assess pain
SBT
Choose sedation
Delerium prevention
Exercise
Family engaement