Wednesday, December 6, 2017

Q: All of the following are clinical criteria to liberate patient from mechanical ventilation except?

A) Pulseox saturation more than or equal to 90 percent

B) Arterial pH more than 7.30
C) Core temperature 38 to 38.5ÂșC
D) Hemodynamic stability, without myocardial ischemia
E) Hemoglobin level more than or equal to 7 mg/dL


Answer: B

Collective task force facilitated by the American College of Chest Physicians, the American Association for Respiratory Care, and the American College of Critical Care Medicine, has divided requirements to initiate patient to liberate from ventilators into basic and optional (clinical) criterias.

Basic criteria includes five major components
  • The cause of the respiratory failure has improved
  • Adequate oxygenation
  • Arterial pH more than 7.25
  • Hemodynamic stability
  • Patient is able to initiate an inspiratory effort
Optional criteria includes
  • Hemoglobin level 7
  • No marked fever
  • Adequate mental status

Reference:

MacIntyre NR, Cook DJ, Ely EW Jr, et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001; 120:375S.

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