Ventilation and Weaning: Difference between revisions
No edit summary |
Evan Thomas (talk | contribs) mNo edit summary |
||
| Line 7: | Line 7: | ||
== Introduction == | == Introduction == | ||
Ventilation can be defined as the process | Ventilation can be defined as the process of exchange of air between the lungs and the ambient air<ref>''Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition''. (2003). Retrieved September 26 2017 from <nowiki>http://medical-dictionary.thefreedictionary.com/ventilation</nowiki></ref>. In the clinical setting, a machine known as a mechanical [http://emedicine.medscape.com/article/304068-overview#showall ventilator] is used to perform this function on patients faced with serious respiratory illness. Weaning is the gradual withdrawal of a patient from dependency on a life-support system or other form of therapy<ref>''Farlex Partner Medical Dictionary''. (2012). Retrieved September 26 2017 from <nowiki>http://medical-dictionary.thefreedictionary.com/weaning</nowiki></ref>. 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> | ||
{{#ev:youtube|v=gk_Qf-JAL84}} | {{#ev:youtube|v=gk_Qf-JAL84}} | ||
| Line 14: | Line 14: | ||
The procedure is as follows: | The procedure is as follows: | ||
*Explanation of the procedure to the patient, assuring them | *Explanation of the procedure to the patient, assuring them it is only for a trial period | ||
*The ventilator support is gradually reduced (e.g. reducing pressure during pressure support) | *The ventilator support is gradually reduced (e.g. reducing pressure during pressure support) | ||
* | *The patient is placed into a better postural position (e.g. sitting upright or half-sitting) | ||
*The airway is suctioned | *The airway is suctioned | ||
*The patient is disconnected from the ventilator and given oxygen or mechanical assistance(CPAP) | *The patient is disconnected from the ventilator and given oxygen or mechanical assistance (CPAP) | ||
*The patient is encouraged to breathe spontaneously | *The patient is encouraged to breathe spontaneously | ||
* | *The patient is monitored for signs of laboured breathing, anxiety or an increase in PaCO<sub>2</sub> | ||
*Extubation should occur as soon as possible because breathing through an endotracheal tube increases the | *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 | *Encourage the patient to cough after being extubated | ||
<br> | |||
{{#ev:youtube|v=8IjADnVbBz4}} | {{#ev:youtube|v=8IjADnVbBz4}} | ||
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 | 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 due to: | ||
*Inspiratory muscle atrophy | *Inspiratory muscle atrophy | ||
*Fatigue | *Fatigue | ||
Revision as of 17:43, 29 September 2017
Original Editor - The Open Physio Project
Top Contributors - Jagunath Selvanathan, Admin, Kim Jackson, Mohit Chand, Evan Thomas, Fasuba Ayobami, Angeliki Chorti, Rachael Lowe, Tony Lowe, WikiSysop, Karen Wilson and Vidya Acharya
Introduction[edit | edit source]
Ventilation can be defined as the process of exchange of air between the lungs and the ambient air[1]. In the clinical setting, a machine known as a mechanical ventilator is used to perform this function on patients faced with serious respiratory illness. Weaning is the gradual withdrawal of a patient from dependency on a life-support system or other form of therapy[2]. 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 it is only for a trial period
- The ventilator support is gradually reduced (e.g. reducing pressure during pressure support)
- The patient is placed into a better postural position (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
- The patient is monitored 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 due to:
- Inspiratory muscle atrophy
- Fatigue
- Paralysis of the diaphragm
- A fear of suffocating
Guidelines[edit | edit source]
The following are links to documents that serves as clinical guidelines to the use of mechanical ventilator and when to commence weaning process;
- http://www.sciencedirect.com/science/article/pii/S0012369216623243
- https://www.health.ny.gov/diseases/communicable/influenza/pandemic/ventilators/docs/ventilator_guidelines.pdf
- http://www.learnicu.org/Docs/Guidelines/AcuteRespiratoryFailure.pdf
- https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0007/239740/ACI14_Man_NIV_1-2.pdf
- http://www.northdevonhealth.nhs.uk/wp-content/uploads/2012/12/Multiprofessional-care-plan-Appendices-only.pdf
- http://www.nejm.org/doi/full/10.1056/NEJMra1203367
- http://neoreviews.aappublications.org/content/18/7/e413?utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=NeoRev_TrendMD_1
References[edit | edit source]
- ↑ Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Retrieved September 26 2017 from http://medical-dictionary.thefreedictionary.com/ventilation
- ↑ Farlex Partner Medical Dictionary. (2012). Retrieved September 26 2017 from http://medical-dictionary.thefreedictionary.com/weaning
