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How To Wean Off Of The Vent After Pneumonia Treatment?
Question: My mother is recovering from a horrible pneumonia and is in the process of being weened off of the vent. My mom is 78 and has CLL and Lung cancer that has been very successfully treated. In fact the pneumonia attacked her healthy lung. My mom has been on PS or cpap during the day. And then SIMV F4 PS 15 35% 02 during the evening. The pulmonary group running the sub acute facility is working very aggressively to ween her and I am extremely grateful for their help. My question is this, her title is not as high as I would like it to be. For weening purposes, they switched her to ps 15 from ps 10, her title volume while on cpap is above 300 but dips below 300 if switched down to ps 10. My question is this, are there people that can actually successfully breathe on their own with a title volume that is below 300?
Brief Answer:
Successful weaning possible.
Detailed Answer:
Hello
Thanks for your query.
There are people who can be successfully weaned even after having a low tidal volume of below 300 if the other important parameters of weaning remain stable as follows -
1. Adequate Oxygenation - PaO2/FIO2 ratio > 200 or FI02 ≤ .40
and Sp02 ≥ 90% and/or PaO2 ≥ 60
2. Adequate Ventilation - PH ≥ 7.30, RR ≤ 35 bpm, VE ≤ 15 lpm, Inspiratory effort by patient
3. Hemodynamic Stability - HR ≤ 140 bpm, SBP 90 – 180 mmHg, No or minimal vasopressors or inotropes
4. No underlying cardiac disorder or electrolyte imbalance
Tidal volume itself is not the only deciding factor for successful weaning rather it is a continuous process of assessing multiple parameters as I have described above. I think if your mother can maintain these outcome parameters well above the desired value then there is every possibility of successful weaning.
If you have further queries you can ask me.
If you are happy with my response you can write a review for me.
Thank you.
Regards,
Dr Arnab Maji
MBBS. MD
Pulmonologist
Successful weaning possible.
Detailed Answer:
Hello
Thanks for your query.
There are people who can be successfully weaned even after having a low tidal volume of below 300 if the other important parameters of weaning remain stable as follows -
1. Adequate Oxygenation - PaO2/FIO2 ratio > 200 or FI02 ≤ .40
and Sp02 ≥ 90% and/or PaO2 ≥ 60
2. Adequate Ventilation - PH ≥ 7.30, RR ≤ 35 bpm, VE ≤ 15 lpm, Inspiratory effort by patient
3. Hemodynamic Stability - HR ≤ 140 bpm, SBP 90 – 180 mmHg, No or minimal vasopressors or inotropes
4. No underlying cardiac disorder or electrolyte imbalance
Tidal volume itself is not the only deciding factor for successful weaning rather it is a continuous process of assessing multiple parameters as I have described above. I think if your mother can maintain these outcome parameters well above the desired value then there is every possibility of successful weaning.
If you have further queries you can ask me.
If you are happy with my response you can write a review for me.
Thank you.
Regards,
Dr Arnab Maji
MBBS. MD
Pulmonologist
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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