Anesthesia Tutorial of the Week Quiz

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There is evidence to suggest that a single spontaneous breathing trial (SBT) has the same predictive value as mutiple SBTs.

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Positive fluid balance has been shown to be a negative predictor.

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This is a proprietary automated weaning mode of ventilation.

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It may be of use when used electively in the weaning process but not to treat respiratory failure after extubation.

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This has not been demonstrated.

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There is evidence to suggest that the predictive value is not altered between the two durations of SBT.

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Any form of bulbar dysfunction reduces the ability of a patient to maintain and/or protect their own airway leading to failure as a result of respiratory failure or aspiration.

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In COPD patients, the duration of weaning and ICU stay may actually be reduced with extubation to NIV.

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This has been demonstrated but is not currently routine practice.

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One study has demonstrated a better predictive value with US as compared to a clinical cuff-leak test

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Whilst its actual value needs to be interpreted in the context of the mode of ventilatory support being provided to the patient, the RSBI has been shown to have a high predictive value in terms of predicting weaning outcome

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This defines difficult weaning according to the European Respiratory Society Task Force Statement.

21Boles JM, Bion J, Connors A et al. Weaning from Mechanical Ventilation. Eur Respir J 2007; 29:1033-1056

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Prolonged weaning failure is defined as patients who fail at least three weaning attempts or require more than 7 days of ventilation following their first SBT. Not surprisingly, these patients consume significant healthcare resources.

21Boles JM, Bion J, Connors A et al. Weaning from Mechanical Ventilation. Eur Respir J 2007; 29:1033-1056

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It is defined as the need for more than 21 consecutive days of mechanical ventilation for 6hrs or more per day .

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The timing of tracheostomy has not demonstrated any relationship with duration of mechanical ventilation.

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10mm is the measurement cut off that has been demonstrated to be associated with delayed weaning.

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Pleural fluid worsens chest wall compliance.

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COPD (versus pneumonia) patients are one of the subsets of patients in which NIV may be of benefit.

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SIMV has not been shown to be particularly useful as a weaning mode when compared to PSV or T-piece SBTs.

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There is limited evidence for automated weaning modes in the intensive care setting.