SCCM Resource Library-Successful Weaning and Extubation

Video Transcription

Video Summary

Timothy Gerard from the University of Pittsburgh presented a talk on successful weaning and extubation for SCCM 2022. The focus of the presentation was on four questions addressed in the 2017 ATS-ACCP joint clinical practice guidelines on liberation from mechanical ventilation. The first question addressed the use of ventilator liberation protocols, which were found to be better than no protocol in reducing the duration of mechanical ventilation. The second question examined the use of pressure augmentation during spontaneous breathing trials, and the evidence showed that using inspiratory pressure during these trials led to quicker extubation. The third question focused on the use of cuff leak tests prior to extubation, and it was found that while cuff leak tests do reduce re-intubation rates, they also prolong the duration of mechanical ventilation. Therefore, cuff leak tests should only be performed in patients with specific risk factors. The final question looked at the use of preventive post-extubation non-invasive ventilation in high-risk patients, and the evidence showed that it was beneficial in reducing mortality rates. Overall, the clinical guidelines recommend using liberation protocols, pressure augmentation, and preventive non-invasive ventilation, but caution against using cuff leak tests in all patients.

Asset Subtitle

Pulmonary, Procedures, 2022

Asset Caption

This session will review the basics of acute respiratory failure for a broad multidisciplinary audience. Topics include the basic pathophysiology of respiratory failure and the management (and associated evidence) of respiratory failure, including noninvasive strategies, ventilator manipulation, and weaning and extubation. A case-based discussion among the speakers will be included at the end.

Meta Tag

Content Type Presentation

Knowledge Area Pulmonary

Knowledge Area Procedures

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Weaning

Tag Extubation

Tag Mechanical Ventilation

Year 2022

Keywords

weaning

extubation

ventilator liberation protocols

pressure augmentation

cuff leak tests

preventive non-invasive ventilation

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