Ventilator Weaning

Separation from mechanical ventilation should occur once the initial process that required ventilation has resolved. Suitability for weaning is indicated by adequate:

• Strength
  
  • To achieve a spontaneous breath
    VC >10mL/kg with Psupp of 5cmH₂O
  • To clear secretions
• Oxygenation
  Normoxia with low PEEP (<8cmH₂O) and FiO₂ (<40%) requirements.
• Work of breathing
  Can be assessed:
  • Clinically
    Gestalt is effective, with a reintubation rate of ~3%.
  • Rapid Shallow Breathing Index
    Given by \(RR \over V_t\), with values >105 significant.
• Alertness
  • Conscious state adequate to protect airway
• Analgesia

---

References