A 58-year-old woman is ventilated on ICU following a severe asthma exacerbation. Current settings: VCV, TV 380 mL (6 mL/kg IBW), RR 10/min, PEEP 5 cmH...

Question

A 58-year-old woman is ventilated on ICU following a severe asthma exacerbation. Current settings: VCV, TV 380 mL (6 mL/kg IBW), RR 10/min, PEEP 5 cmH2O, FiO2 0.3, I:E ratio 1:5. She has improved clinically and the team plans a spontaneous breathing trial. ABG on current settings: pH 7.42, PaO2 12.0 kPa, PaCO2 5.2 kPa, HCO3 24 mmol/L. Which of the following is NOT a prerequisite for commencing an SBT?

Accepted Answer

Complete resolution of the underlying condition that led to intubation

Answer

Adequate oxygenation: PaO2/FiO2 >150 mmHg or SpO2 >90% on FiO2 ≤0.4 and PEEP ≤8 cmH2O

Answer

Haemodynamic stability - no new or escalating vasopressor requirement

Answer

Adequate conscious level - patient able to initiate respiratory effort

Answer

Absence of significant metabolic acidosis

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