A 62-year-old man has been ventilated for 10 days following abdominal sepsis. He is now recovering, sedation has been weaned, and he is alert and foll...

Question

A 62-year-old man has been ventilated for 10 days following abdominal sepsis. He is now recovering, sedation has been weaned, and he is alert and following commands. FiO2 0.35, PEEP 5 cmH2O. He is haemodynamically stable without vasopressors. ABG on current settings: pH 7.42, PaO2 11.2 kPa, PaCO2 5.1 kPa, HCO3 24 mmol/L. RSBI (f/VT) is 65 breaths/min/L. What is the most appropriate next step?

Accepted Answer

Perform a 120-minute spontaneous breathing trial on PSV 5 cmH2O/PEEP 5 cmH2O

Answer

Perform a 30-minute spontaneous breathing trial on T-piece

Answer

Proceed directly to extubation without a formal SBT

Answer

Continue current ventilatory support and reassess in 24 hours

Answer

Perform a tracheostomy to facilitate weaning

uk-fficm MCQ (SBA): Weaning from Mechanical Ventilation