portable ventilator machine weaning is conditional,not just off of.Achieve at least under the following conditions in order to consider offline:
1.The disease control;
2.The infection control;
3.Sputum less cough and patients have the power;
4.The patient can breathe spontaneously breathing muscle recovery;
5.The nutritional status improved.Then to go offline.
6.Overcome airway resistance within the minimum required suction pressure,so that fresh air can reach the alveoli,the complete gas exchange.
7.The body needs to meet the ventilation.Per kilogram of body weight may refer to estimates.
8.The patient does not confrontation.Try to use automatic synchronization mode.
9.Set the required alarm parameters (such as asphyxia,high pressure,etc.) to ensure patient safety.
10.The use of appropriate models and parameters,so that patients gradually offline.
If you can not reach these conditions forced offline,the patient may again respiratory failure.
from the method of ventilator machine:
Methods classify a doctor specializing in method parameters.
1.By CMV-SIMV-CPAP mode.
2.Gradually reduce PS offline.
3.Fi02 reduced to 30%.
4.From the ventilator by.
5.The cycle stability.
6.Tidal volume> 5ml/Kg.
7.Respiratory rate <35 beats/min.
8.Blood gas analysis in CPAP 5 cmH2O,under FiO230%,observed for 24 sales gas analysis pH> 7.35,PO2> 60mmHg.,PCO2﹤ 45mmHg.
The method of classification II.Clinicians recommend methods.
All patients were using drager evita2 ventilator mechanical ventilation.(Tidal volume 8-10ml / kg,f12 beats / min,fio240%.)Be in stable condition,considering offline,first gradually changing breathing patterns(From the original ippv-simv-asb + cpap),Etc.asb + cpap then began to adapt 24h offline.3-5 times daily beginning disabled,every 30 minutes or so,then gradually increased every 1-2 hours deactivated.During disabled patients without exception,then gradually increase the down time,until two consecutive day the patient can breathe on his own,before considering the overnight shutdown.Must go through a period of respiratory muscle exercise and physical therapy,can not be rushed,so come to naught,once from the ventilator in good condition,consider extubation.
With the improvement of the lives of human values,critically ill patients to use medical care and rescue breathing machine and more common,nurses must conscientiously study and master the use of various methods of care and use of ventilator patient needed to have a high degree of responsibility,careful observation,to understand the changes in the patient's condition and body physiology,psychological needs,and only the correct use can improve the survival rate of respiratory failure,otherwise it will have adverse consequences for long-term use of ventilator-dependent patients when weaning,must address the condition of patients with different characteristics,mental status,and tolerance,the development of scientific nursing program,both physical and psychological care,in order to achieve satisfactory results.
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