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proven methods of ventilator weaning

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March 29, 2008, 11:44 AM
jogger
proven methods of ventilator weaning
Are there a few proven successful vent. weaning methods out there to choose from for our patients.
March 29, 2008, 05:47 PM
JeffWhitnack
Go to

http://www.rcjournal.com/

down on left side is Clinical Practice Guidelines.

Basically no "weaning" ala gradual support reduction. Everyday look at each patient. If they pass clinical criteria, NOT per any "weaning parameters" then do a spontaneous breathing trial----CPAP mode with or without any Peep or PS, minimal Peep and PS, T-tube, ATC, etc. If they pass then consider extubation. If they fail then put them back on a "stable and non-fatigueing mode". Don't mess around reducing support. Next day, same process. Clinical criteria refers to temp, hemodynamics, FIO2/Peep requirements, etc.

THe concept of "weaning" needs to be tossed out. It's not just semantics but rather infects our thinking and actions. We should view it as fledging--taking care of the bird in the nest. When the bird is ready to fly out he will....no matter what knnob twirling we do.
April 01, 2008, 06:20 AM
light
jogger,
you might want to try a simple search through the RCjournal using "weaning" as your criterea. you will find some articles, one being

Evidence-Based Ventilator Weaning and Discontinuation
Neil R MacIntyre MD FAARC

The other question is what type of weaning are you talking about? shortterm, longterm. Weaning methods change based on what type of facility you are at.


Light
April 02, 2008, 09:32 AM
Bill C
Jogger,
I agree with light. But, you also have to modify vent weaning to meet tht patients needs both physically and psychologically.
You can also check weaning protocols, they seem to have some basic commonalities and standards.