Evaluation of simple criteria to predict successful weaning from mechanical ventilation in intensive care patients

Abstract

A simple checklist can assist nurse assessment of suitability for weaning and could be used as a trigger to commence a weaning protocol. The day on which criteria are met is a useful way of stratifying patients for likely patterns of weaning.

Sequential invasive-noninvasive mechanical ventilation weaning strategy for patients after tracheostomy

“…Premature decision of switching may lead patients to experience relapses, but if you were asleep at the switching point, the patients may suffer from ventilator-associated pneumonia, ventilator dependence and failure of treatment. Many researchers [25][26][27][28] have tested spontaneous breathing trial, heart-rate variability and the pulmonary infection control window as weaning time. In our study, we applied the pulmonary infection control window as the critical switching point.…”

Weaning from mechanical ventilation

“…1 The study was performed in a unit without an established weaning protocol and 89 out of 293 (30%) patients did not achieve ventilator independence compared to 20% complications (including re-intubation or prolonged ventilation) in the Ely study. 2 We remain unconvinced that a protocol for weaning changes practise, over and above educational support to nurses, in a general purpose UK intensive care unit (ICU). Our study of outcomes in patients, referred to a regional weaning centre, 3 our use of noninvasive ventilation (NIV) was to enable decannulation of tracheostomised slowwean patients and not as an alternative way to support spontaneous breathing.…”

“…1 In the UK, this method of patient assessment is not commonly applied and other strategies may be associated with a lower re-intubation rate. 2 Reintubation may be an independent adverse prognostic factor in intensive care unit patients. 3 Regarding non-invasive ventilation following extubation as a weaning strategy, the paper by Ferrer et al 4 cited by the authors involved patients, predominantly with chronic obstructive pulmonary disease (COPD), who failed SBTs for three consecutive days.…”

Dynamic functional residual capacity can be estimated using a stress–strain approach

“…Patients admitted to the intensive care unit (ICU) with acute lung injury (ALI) or its more severe form, acute respiratory distress syndrome (ARDS) [1][2][3] have mortality rates ranging from 20% to 70% [4]. ALI or ARDS occurs when the lung is inflamed and fills with fluid and cellular infiltrate causing a loss of functional lung units.…”