A 46-year-old male patient (IBW = 85 kg)who was injured in a motor vehicle accident has been receiving invasive mechanical ventilation for 24 hours.The patient is awake and alert and looks comfortable on these settings: VC-SIMV with pressure support of 5 cm H₂O;set rate = 8 breaths/min;set V_T= 500 mL;F_IO₂ = 0.4;PEEP = 5 cm H₂O.A 10-minute spontaneous breathing trial (SBT)yields this information: f = 30 breaths/min,RSBI = 145,P_0.1 = 10 cm H₂O.What should the respiratory therapist suggest to the physician during patient rounds?

Question

Quizplus · Accepted Answer

The RSBI is at a level that suggests the patient is not ready for weaning.An RSBI below 105 suggests that weaning is likely to be successful.The P_0.1 is a measurement of the drive to breathe.The patient achieved 10 cm H₂O,which indicates a high drive to breathe and suggests that weaning from mechanical ventilation is not likely to succeed.This information is a strong indicator that the patient should not begin active weaning at this time and should be continued on the original settings,because the patient was comfortable on those settings.

A 46-Year-Old Male Patient (IBW = 85 Kg)who Was Injured