TABLE 1.
Key factors to be assessed daily when considering the readiness of a patient to wean
| Clinical assessment |
| Adequate cough |
| Absence of excessive tracheobronchial secretions |
| Resolution of the acute phase of the disease for which the patient was intubated |
| Objective measurements |
| Stable cardiovascular status (i.e. heart rate ≤140 beats·min−1, systolic blood pressure 90–160 mmHg, no or minimal vasopressors) |
| Stable metabolic status |
| Adequate oxygenation |
| Arterial oxygen saturation >90% on FIO2 ≤0.4 (or PaO2/FIO2 ≥150 mmHg) |
| PEEP ≤8 cmH2O |
| Adequate pulmonary function |
| Respiratory rate ≤35 breaths·min−1 |
| Maximal inspiratory pressure ≤ −20 to −25 cmH2O |
| Tidal volume >5 mL·kg−1 |
| Vital capacity >10 mL·kg−1 |
| Rapid shallow breathing index (respiratory rate/tidal volume) ≤105 breaths·min−1·L−1 |
| No significant respiratory acidosis |
| Adequate mentation |
| No sedation or adequate mentation on sedation (or stable neurological patient) |
| Tympanic temperature between 36°C and 38°C |
| No relevant electrolyte disorder and haemoglobin level 70–80 g·L−1 |
FIO2: inspiratory oxygen fraction; PaO2: arterial oxygen tension; PEEP: positive end-expiratory pressure. Reproduced and modified from [9] with permission.