Abstract
Weaning from mechanical ventilation is a poorly understood and often frustrating phase of management of acute respiratory failure (ARF) [6]. With the exception of diseases known to require prolonged, uninterrupted, mechanical ventilation (MV)—i.e., severe tetanus, polyneuritis, and massive chest trauma with severe flailing—consideration should be given to weaning from MV as soon as certain simple criteria are met. These criteria are as follows: (a) vital capacity > 4–5 ml/kg, (b) inspiratory force > 10 cm H2O, \( \left( c \right)\,\,A - a{\rm{ }}{P_{{O_2}}}\; < \;350\;torr, \) (d) positive end-expiratory pressure requirement < 10 cm H2O, (e) stable cardiovascular system, (f) chest-wall flailing not severe, and (g) close supervision by experienced physicians.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Beach, T., Millen, E., and Grenvik, A. (1973). Hemodynamic response to discontinuance of mechanical ventilation. Crit. Care Med. 1:85–90.
Breivik, H., Grenvik, A., Millen, E., and Safar, P. (1973). Normalizing low arterial CO2 tension during mechanical ventilation. Chest 63:525–531.
Downs, J. B., Klein, E. F., and Desautels, D. A. (1973). Intermittent mandatory ventilation: A new approach to weaning patients from mechanical ventilation. Chest 64:331–335.
Froese, A. B., and Bryan, A. C. (1974). Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology 41:242–255.
Goldman, M. D., and Mead, J. (1973). Mechanical interaction between the diaphragm and rib cage. J. Appl. Physiol. 35:197–204.
Hodgkin, J. E., Bowser, M. A., and Burton, G. G. (1974). Respirator weaning. Crit. Care Med. 2:96–102.
Peters, R. M., Hilberman, M., and Hogan, J. S. (1972). Objective indications for respiratory therapy in post-trauma and post-operative patients. Am. J. Surg. 124:262–269.
Pilon, R. N., and Bittar, D. A. (1973). The effect of positive end-expiratory pressure on thoracic-duct lymph flow during controlled ventilation in anesthetized dogs. Anesthesiology 39:607–612.
Pontoppidan, H., Geffin, B., and Lowenstein, E. (1973). Acute Respiratory Failure in the Adult. Boston: Little, Brown.
Suwa, K., Geffin, B., Pontoppidan, H., and Bendixen, H. H. (1968). A nomogram for dead-space requirement during prolonged artificial ventilation. Anesthesiology 29:1206–1210.
Trichet, B., Falke, K., and Togot, A. (1975). The effect of preexisting pulmonary vascular disease on the response to mechanical ventilation with PEEP following open-heart surgery. Anesthesiology 42:46–57.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 1978 Springer-Verlag New York Inc.
About this chapter
Cite this chapter
Pontoppidan, H., Browne, D.R.G. (1978). Weaning from Mechanical Ventilation. In: Critical Care Medicine Manual. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-9932-5_6
Download citation
DOI: https://doi.org/10.1007/978-1-4612-9932-5_6
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-9934-9
Online ISBN: 978-1-4612-9932-5
eBook Packages: Springer Book Archive