Ventilation and Weaning: Difference between revisions
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'''Weaning''' a patient from a Ventilator occurs when the condition of the patient improves and a decision is made to remove them from the ventilator through a trial of spontaneous breathing through the endotracheal tube and eventually extubation (removal of the tube).<br> | '''Weaning''' a patient from a Ventilator occurs when the condition of the patient improves and a decision is made to remove them from the ventilator through a trial of spontaneous breathing through the endotracheal tube and eventually extubation (removal of the tube).<br> | ||
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== Procedure == | == Procedure == | ||
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*Extubation should occur as soon as possible because breathing through an endotracheal tube increases the [[Work of breathing]]. | *Extubation should occur as soon as possible because breathing through an endotracheal tube increases the [[Work of breathing]]. | ||
*Encourage the patient to cough after being extubated.<br> | *Encourage the patient to cough after being extubated.<br> | ||
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Patients may be extubated when they are alert, show a stable breathing pattern and control their airway. Difficulties in weaning patients from a ventilator can occur because of: | Patients may be extubated when they are alert, show a stable breathing pattern and control their airway. Difficulties in weaning patients from a ventilator can occur because of: | ||
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*Paralysis of the diaphragm | *Paralysis of the diaphragm | ||
*A fear of suffocating<br> | *A fear of suffocating<br> | ||
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== References == | == References == | ||
Revision as of 00:12, 27 September 2017
Original Editor - The Open Physio Project
Top Contributors - Jagunath Selvanathan, Admin, Kim Jackson, Mohit Chand, Evan Thomas, Fasuba Ayobami, Rachael Lowe, Tony Lowe, WikiSysop, Karen Wilson, Vidya Acharya and Angeliki Chorti
Introduction[edit | edit source]
Weaning a patient from a Ventilator occurs when the condition of the patient improves and a decision is made to remove them from the ventilator through a trial of spontaneous breathing through the endotracheal tube and eventually extubation (removal of the tube).
Procedure[edit | edit source]
The procedure is as follows:
- Explanation of the procedure to the patient, assuring them that it is only for a trial period.
- The ventilator support is gradually reduced (e.g. reducing pressure during pressure support).
- Choose a better posture for the patient (e.g. sitting upright or half-sitting).
- The airway is suctioned.
- The patient is disconnected from the ventilator and given oxygen or mechanical assistance (CPAP).
- The patient is encouraged to breathe spontaneously.
- Look for signs of laboured breathing, anxiety or an increase in PaCO2.
- Extubation should occur as soon as possible because breathing through an endotracheal tube increases the Work of breathing.
- Encourage the patient to cough after being extubated.
Patients may be extubated when they are alert, show a stable breathing pattern and control their airway. Difficulties in weaning patients from a ventilator can occur because of:
- Inspiratory muscle atrophy
- Fatigue
- Paralysis of the diaphragm
- A fear of suffocating
