Friday, March 27, 2009

Weaning: APRV optimization of settings.

When utilizing certain ventilators there is no need to switch to a different mode of ventilation to wean the patient from APRV. Weaning is accomplished simply by decreasing the CPAP level (p-High) while simultaneously increasing the CPAP time (t-High). 
Decreasing the p-High in increments of 1-2 cmH2O, while increasing the t-High by 0.5 seconds per cmH2O reduction in p-High.
When p-High is at an acceptable CPAP level, the patient may be considered for extubation. Additionally, spontaneous breaths may be supported with automatic tube compensated to elevate work of breathing associated with the artificial airway.