Ventilation and Weaning
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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
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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