Why can't my mother be extubated yet in ICU after a Pneumonia? Quick tip for families in ICU

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-why-cant-my-mother-be-extubated-yet-in-icu-after-a-pneumonia/

Why can't my mother be extubated yet in ICU after a Pneumonia? Quick tip for families in ICU

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So currently, we are working with a client who has their 78-year-old mom in ICU for a couple of weeks with a bacterial pneumonia. The lady had a trial extubation a few days ago and it failed. Initially, the intensive care team talked about doing a tracheostomy if the trial extubation fails, but now they are sort of stalling a little bit, not talking further about it. So, the client reached out to us and asked, why would that be?

So, when we looked at parameters of the ventilator, for example, we saw that the client is probably very close to getting off the ventilator to begin with, and it would be so much better to have the ventilator removed and not have the tracheostomy. It does make sense to avoid the tracheostomy if you can. There are situations where you can, and there are situations where you can’t.

Simply, this lady is on 10 of PEEP (positive end expiratory pressure) and 12 of pressure support. Her respiratory rate seems stable. Her tidal volume seems stable. We haven’t seen an arterial blood gas yet because some of it will come down to that. We haven’t seen a chest X-ray report either, but the client has said that there’s probably some infiltrates on the X-ray and that might be an obstacle for that. So, those are the challenges there.

But it does make sense to hold off with the tracheostomy maybe for a couple of more days. Do another trial extubation if need be, and if that can be achieved.

Continue reading...
https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-why-cant-my-mother-be-extubated-yet-in-icu-after-a-pneumonia/