Every intubated patient deserves a spontaneous breathing trial every day!
When should you think about extubating someone?
- mental status? Do they have the cortical connections to breathe on their own? Are they hypoventilating?
- M/S strength: do they have good respiratory muscles?
- Is their lung disease resolved?
There are several ways to “wean” someone off a vent:
- T-piece for 30 mins. CHF.
- PSV 8/5 for 2 hrs. Esp good for COPD or hypercarbic resp distress
- Extubate to Bipap. This gives a little extra PEEP so also good for COPD.