weaning from mechanical ventilation is the process of transferring the work of breathing from the
ventilator to the patient some patients can tolerate rapid weaning which involves an abrupt
termination of ventilatory support other patients may require gradual removal from the ventilator
in order for weaning to be successful in this video we will discuss the process of weaning
and provide you with an easy to follow overview of this topic so if you're ready let's get into it
as previously mentioned weaning is the process of discontinuing mechanical ventilation and allowing
the patient to breathe spontaneously the ability to wean a patient from the ventilator is dependent
on many factors including the following the type of respiratory disease that is present
the severity the patient's age the presence of comorbidities and the length of time that they
were on the ventilator for example a patient who was only on the ventilator for 24 hours
is more likely to experience weaning success than a patient who has been on the ventilator for weeks
due to a severe respiratory illness in general the longer the patient is on the ventilator the more
difficult weaning becomes but now let's talk about weaning success which is defined as the patient
being able to tolerate spontaneous breathing for 48 hours following extubation without
the need for re-intubation surgical patients are more likely to experience weaning success
than those with a chronic disease also patients who are younger have fewer comorbidities and have
a shorter duration of mechanical ventilation are also more likely to experience weaning success
on the other hand weaning failure is defined as the failure of a spontaneous breathing trial
or the need for re-intubation within 48 hours of being removed from mechanical ventilation
the longer the patient is on the ventilator the greater the risk of weaning failure patients with
a chronic disease such as copd are more likely to experience weaning failure than those with
an acute condition such as a surgical procedure there are several pathophysiologic cardiac and
dietary conditions that can hinder a successful weaning outcome some examples include fever
infections renal failure sepsis sleep deprivation hypertension hypotension fluid imbalance anemia
caloric deficit acid-base imbalance and an electrolyte imbalance patients with chronic lung
diseases are also at an increased risk of weaning failure so now we need to talk about the weaning
criteria when assessing a patient's readiness to wean from mechanical ventilation there are some
criteria that must be met the first step for considering weaning requires resolution of the
acute phase of the disease that caused mechanical ventilation in the first place then the patient
must have an adequate cough with manageable secretions and they must be hemodynamically stable
if so then you can proceed to check the other criteria which include acceptable abg results
an acceptable frequency acceptable tidal volume vital capacity minute ventilation maximum
inspiratory pressure or negative inspiratory force maximum expiratory pressure rapid shallow
breathing index acceptable oxygenation acceptable pf ratio acceptable shunning acceptable alveolar
to arterial oxygen gradient static compliance aoa resistance dead space the tidal volume ratio and
the patient must pass the spontaneous breathing trial if the patient meets these criteria then
extubation can be considered which involves removing the endotracheal tube from the patient's
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think you will enjoy and just a quick reminder we are not doctors this video is for informational
purposes only thank you so much for watching have a blessed day and as always real easy my friend