呼吸机脱机困难的ABCDE流程
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ABCDE
Structured Approach for Weaning Failure
Introduction
• Approach for weaning
– Parameters / indications – Trials
• Weaning failure
– No pass a SBT – Reintubation 48 hrs post-extubation
COPD
PEEPi
• • • • •
Inspiratory threshold Increase work of breathing Diaphragm at a suboptimal position Patient-ventilator asynchrony Ineffective triggering
Brain
Cardiac
DiapΒιβλιοθήκη Baiduragm
Endocrine
Thanks
Focus
• Weaning “ABCDE”
– Airway – Brain – Cardiac – Diaphragm – endocrine
Airway/lung
Resistance of upper airway
• Tracheal obstruction more than 4 weeks on MV • The work of breathing increases post extubation more 5.5 ds on MV
Structured Approach for Weaning Failure
Introduction
• Approach for weaning
– Parameters / indications – Trials
• Weaning failure
– No pass a SBT – Reintubation 48 hrs post-extubation
COPD
PEEPi
• • • • •
Inspiratory threshold Increase work of breathing Diaphragm at a suboptimal position Patient-ventilator asynchrony Ineffective triggering
Brain
Cardiac
DiapΒιβλιοθήκη Baiduragm
Endocrine
Thanks
Focus
• Weaning “ABCDE”
– Airway – Brain – Cardiac – Diaphragm – endocrine
Airway/lung
Resistance of upper airway
• Tracheal obstruction more than 4 weeks on MV • The work of breathing increases post extubation more 5.5 ds on MV