Abstract
The term weaning is used to describe the process of gradual ventilatory support discontinuation so the patient progressively assumes the entire respiratory effort and work of breathing till the complete independence from the mechanical ventilator. Time spent in the weaning process is about 40–50% of the total duration of MV. In the elder patients, the interruption of mechanical support and the rapid extubation play an important role to ensure the best clinical outcome. Reducing the length of mechanical ventilation decreases the risk of complications (e.g., infections, injury to the lungs and other organs), but premature discontinuation of mechanical ventilation can produce other complications and increase mortality. This chapter describes extubation and reintubation conditions of elder patients who require weaning from MV during ICU recovery. Risk factors and complications of planned extubation failure in elder patients are generally different from younger ages and they are affected by the severity of illness, inability to handle secretions, age, upper airway obstruction, weak and ineffective cough, muscular weakness, underlying cardiopulmonary disease, and low albumin levels <2.5 g/dL.
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Abbreviations
- BNP:
-
B-type natriuretic peptide
- ET:
-
Endotracheal tube
- FiO2 :
-
Fraction of inspired oxygen
- GCS:
-
Glasgow coma scale
- ICU:
-
Intensive care unit
- MAP:
-
Mean arterial pressure
- MOF:
-
Multiple organ failure
- MV:
-
Mechanical ventilation
- P/F:
-
Oxygen arterial pressure/fraction of oxygen inspired
- PEEP:
-
Positive end-expiratory pressure
- PEF:
-
Peak expiratory flow
- PSV:
-
Pressure support ventilation
- RSBI:
-
Rapid shallow breathing index
- SBT:
-
Spontaneous breathing trial
- V t :
-
Tidal volume
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Vargas, M., Servillo, G., Acampora, A. (2020). Extubation and Reintubation Conditions. In: Esquinas, A., Vargas, N. (eds) Ventilatory Support and Oxygen Therapy in Elder, Palliative and End-of-Life Care Patients . Springer, Cham. https://doi.org/10.1007/978-3-030-26664-6_21
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DOI: https://doi.org/10.1007/978-3-030-26664-6_21
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