Protocolized Ventilator Weaning Verses Usual Care

Respiratory therapist determined extubation readiness based on: patent and protected airway; adequate secretion clearance; suction requirement ≤ every 2 hours; FiO2 \< 50% and PEEP = 5; and hemodynamic stability without circulatory support. The SBT included CPAP = 5 mmHg at FiO2 ≤ 0.4. Patients were assessed after 3-minutes for appropriateness to continue (SaO2 ≥ 92%; no arrhythmia; RSBI \< 105 breaths/min/L). Respiratory distress signs included RR \> 30 breaths/min, SaO2\< 90%, HR \> 140 beats/min, or a sustained change in HR of \>20%, systolic BP \>200 mmHg or \<80 mmHg, or agitation, anxiety, or diaphoresis without other cause. The SBT lasted 120 min in accordance with prior studies. Upon SBT completion, the RSBI was re-measured and an ABG was obtained.