2. Spontaneous Breath Trial:
a) Baseline blood gas and clinical parameters to be documented.
b) SBT to be performed using either an incremental reduction of pressure
support to a PSV of 5-7 cm or by a T-piece trial, which was to be
carried out for a duration of 30 minutes to a maximum of 2 hours.
c) Assess intolerance to SBT:
Rise in pCO2> 8mm Hg or an absolute value
> 50 mm Hg
PO2< 50-60 mm Hg or
SpO2< 90% on FiO2 > 50%
pH < 7.32 or decrease more than 0.07 units
RR > 35/min or increase of > 50%
New onset hypotension (SBP < 90mm Hg),increase in SBP more
than 20% or new onset arrhythmia
Tachycardia with a heart rate > 140 beats/min or increase
more than 20%
Worsening of GCS
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3. Extubation screen :
Appropriate alertness and muscle function (assessed by GCS and head
lift-off bed for > 5 seconds)
Adequate cough reflex (assessed via suctioning frequency which should
not have been more frequent once every two hours)
Adequate airway patency assessed using a cuff-leak test
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Extubation
If the patient satisfied all of the above criteria, they were extubated
to either room air, high flow oxygen or NIV depending on the underlying
condition.
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