Meets all Extubation Criteria

Slides:

Advertisements

Similar presentations

Weaning Modes and Protocol

Advertisements

Respiratory Calculations

1 Pre-ICU Training CHEST Mechanical Ventilatory Support 2008/6/20.

PHILIP L. KALARICKAL, M.D., M.P.H. Ventilators and ABG’s.

Mechanical Ventilaton Ramon Garza III, M.D.. Indications Airway instability Most surgical patients or trauma Primary Respirator Failure Mostly medical.

“… an opening must be attempted in the trunk of the trachea, into which a tube of reed or cane should be put; you will then blow into this, so that the.

Copyright © 2013, 2009, 2003, 1999, 1995, 1990, 1982, 1977, 1973, 1969 by Mosby, an imprint of Elsevier Inc. Chapter 47 Discontinuing Ventilatory Support.

Chapter 47 Discontinuing Ventilatory Support. Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Objectives  List factors.

Ventilatory Parameters

The SLRH Ventilator Weaning Protocol Workgroup

Sahar Elkaradawy Assistant Professor in Anaesthesia and Intensive Care Unite.

Accelerated Ventilator Weaning Guideline A path to excellence! Click Here A path to excellence! Click Here.

Initiation of Mechanical Ventilation

Supplemental Oxygen & Ventilators

HOW TO PICK INITIAL SETTINGS FOR A MULTIPLE CHOICE TEST Mechanical Ventilation.

Weaning from Mechanical Ventilation

J. Prince Neelankavil, M.D.

ICU 101 a.k.a. “Papers You Should Know” Ashley Henderson, MD May 4, 2010.

Objectives Discuss the principles of monitoring the respiratory system

Ventilator Modes & RN Role of Ventilator Patients in ICU

Ventilator Check It’s a thorough process that should take longer than 2 minutes!

Noninvasive Oxygenation and Ventilation

MECHANICAL VENTILATION

1 Life Products LP-6, LP 6 Plus and LP 10 Home Ventilator By Bryce Younger.

Mechanical Ventilation BY: Jonathan Phillips. Introduction Conventional mechanical ventilation refers to the delivery of full or partial ventilatory support.

MECHANICAL VENTILATION

Setting the Vent & Problems. 2 Aspects Oxygenation Ventilation.

Dr Chaitanya Vemuri Int.Med M.D Trainee.  The choice of ventilator settings – guided by clearly defined therapeutic end points.  In most of cases :

How To Ventilate ICU Patient Dr Mohammed Bahzad MBBS.FRCPC,FCCP,FCCM Head Of Critical Care Department Mubarak Alkbeer Hospital.

Weaning and Discontinuation of Ventilatory Support

Emídio Lima MD, PhD. Mortality Increases with the Duration of Mechanical Ventilation and Weaning Failure.

Spontaneous Awakening and Breathing Trials Brad Winters MD, PhD March 14, 2013.

Basic Concepts in Adult Mechanical Ventilation

Discontinuation and Weaning from Mechanical Ventilation

Respiratory Ventilation

Principles of Mechanical Ventilation RET 2284 Module 7.0 Discontinuation From Mechanical Ventilation.

CLINICAL ALGORITHM FOR THE MANAGEMENT OF INTUBATED PATIENTS PRESENTING WITH CHANGES VISSIBLE ON CxR Next step in the algorithm.

Lung Protective Jet Ventilation Basic Lung Protective Strategy for Treating RDS and Air Leaks with HFJV.

Mechanical Ventilation 1

WEANING The Discontinuation of Ventilatory Support By Adriana Adams and Cesar Mancillas.

1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license.

3 nd LECTURE VENTILATORS Part One. Ventilators One of the major life support systems. Ventilators take over the vital role of the respiratory muscles.

APPROACH TO ASSESSMENT AND WEANING OFF THE MECHANICAL VENTILATOR AT THE BEDSIDE DR. MUNIRA DILAWER GHEEWALA.

Cenk Kirakli, MD ; Ilknur Naz, PT, MS ; Ozlem Ediboglu, MD ; Dursun Tatar, MD ; Ahmet Budak, MD ; and Emel Tellioglu, MD A Randomized Controlled Trial.

PRESSURE CONTROL VENTILATION

“Top Twenty” Session Review for Mechanical Ventilation Concepts What you should remember from the Fall… RET 2264C-12.

John F. McConville, M.D., and John P. Kress, M.D. New England Journal of Medicine (2012) December Vol. 367 Weaning Patients from the Ventilator Journal.

Weaning From Mechanical Ventilation

Mechanical Ventilation

Principles of Mechanical Ventilation Magdy M Khalil, MD, EDIC Prof. Pulmonary& Critical Care Medicine.

PEEP Residual Volume Forced Vital Capacity EPAP Tidal Volume A-a gradient IPAP PaCO2 RR ARDS BIPAP BiPAP NIV PaO2 IBW Plateau Pressure FiO2 A/C SIMV.

Multi-parameter data collection example

Weaning From The Ventilator

APPROACH TO ASSESSMENT AND WEANING AT THE BED SIDE

Basic Concepts in Adult Mechanical Ventilation

Mechanical ventilation .

MICU Sedation Vacation/SBT Decision Tree

Introduction to ventilation

CUSP 4 MVP-VAP Data Facilitator Discussion – 1

ABCDEF Checklist Instructions:

Lung volume variations during quiet breathing (grey lines) and vital capacity (blue lines) in an healthy subject (left) and a muscular dystrophy patient.

Respiratory impedance during weaning from mechanical ventilation in a mixed population of critically ill patients J. Sellares, I. Acerbi, H. Loureiro,

Flow chart of pressure support test and spontaneous breathing trial (SBT). Flow chart of pressure support test and spontaneous breathing trial (SBT). The.

ABCDEF Checklist Instructions:

Running title: NAVA may reduce weaning duration from mechanical ventilation A randomized controlled trial to compare Neurally adjusted ventilatory assist.

Asynchrony index at baseline and following optimization of pressure support (PS) level (A), and following optimization of mechanical inspiratory time (mechanical.

The peak flows (60 L/min) and flow patterns are the same for all the breaths. The peak flows (60 L/min) and flow patterns are the same for all the breaths.

This tracing depicts 30 seconds of information.

Study protocol. Study protocol. Subjects with hemodynamic, respiratory, and neurologic stability and positive predictive index were randomized to 3 groups.

Minute-by-minute means of breathing variables during the spontaneous breathing trial for the groups of subjects with trial success (n = 32) and failure.

Presentation transcript:

Meets all Extubation Criteria . 5:00-noon daily, Assess patient for Spontaneous Breathing Trial (SBT) Sp02 > 92% PEEP < to 8 cm H20 Fio2 < 0.4 – 0.5 Minute ventilation is < 20 L/min Hemodynamic stability (Off Nitric and/or Flolan) HR > 50 < 140bpm SBP > 90 < 180 mmHg Patient initiates spontaneous inspiratory efforts Patient Performs the following simple commands: Open and close eyes Open and close mouth Cough Perform forced vital capacity maneuver, achieving double the baseline tidal volume Meets All Readiness Criteria NO VAD PT’S Check with NP first Yes Begin SBT with Fi02 of .4-.5, wait 3 minutes, measure Rapid Shallow Breathing Index (RSSBI), (SBT can be either T-Piece, PS + 5/+ 5 or TC Trial Resume Appropriate ventilator setting, Allow patient to rest for 24 hours NO RSBI <105 bpm/L RSBI >105 bpm/L Continue SBT. After 60 minutes assess whether: RR< 35 bpm Sp02 > 92% Change in HR < 20% Change in SBP < 20% Pt is not agitated, diaphoretic or anxious Pt coughs on command Meets all Extubation Criteria Yes Page Physician: Inform physician that patient meets extubation criteria Either: Obtain verbal order for extubation or wait for physician to arrive for bedside assessment within 15 minutes