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After Coming Off the Ventilator, Is There a Chance to Go Again Ventilated?
After Coming Off the Ventilator, Is There a Chance to Go Again Ventilated?
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Taking patient off a ventilator is usually a gradual process, often referred to as weaning. There are numerous articles that describe this process in detail, and clear protocols have been developed. Assessment of a patient’s readiness for removal of the endotracheal tube in the ICU is based on:
ability to maintain a patent upper airway
ability to cough and clear secretions
ability to follow 4 simple tasks (ie, open eyes, track with eyes, grasp with hands, and stick out tongue)
adequate ABG (Arterial Blood Gas)
sitting up in bed
Reintubation is common following extubation and discontinuation of mechanical ventilation. The extubation failure rate considered acceptable has empirically been set at 10–15%, but avoiding reintubation remains an important clinical goal.
Extubation failure-need for reintubation within 72 h of extubation, is common in intensive care unit (ICU). It can cause increased morbidity, higher costs, higher ICU and hospital length of stay (LOS) and mortality.
Due to the high economic and personal costs of prolonged weaning and extubation failure, it is imperative that the critical care nurse monitor factors such as patient discomfort, fatigue, sweating, work of breathing, mental status, and vital signs during weaning. In addition, measures such as these can be taken prior to the start of a Spontaneous Breathing Trial (SBT) to encourage successful breathing:
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https://intensivecarehotline.com/questions/after-coming-off-the-ventilator-is-there-a-chance-to-go-again-ventilated/
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