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Extubation and Reintubation Conditions

  • Maria VargasEmail author
  • Giuseppe Servillo
  • Aniello Acampora
Chapter

Abstract

The term weaning is used to describe the process of gradual ventilatory support discontinuation so the patient progressively assumes the entire respiratory effort and work of breathing till the complete independence from the mechanical ventilator. Time spent in the weaning process is about 40–50% of the total duration of MV. In the elder patients, the interruption of mechanical support and the rapid extubation play an important role to ensure the best clinical outcome. Reducing the length of mechanical ventilation decreases the risk of complications (e.g., infections, injury to the lungs and other organs), but premature discontinuation of mechanical ventilation can produce other complications and increase mortality. This chapter describes extubation and reintubation conditions of elder patients who require weaning from MV during ICU recovery. Risk factors and complications of planned extubation failure in elder patients are generally different from younger ages and they are affected by the severity of illness, inability to handle secretions, age, upper airway obstruction, weak and ineffective cough, muscular weakness, underlying cardiopulmonary disease, and low albumin levels <2.5 g/dL.

Abbreviations

BNP

B-type natriuretic peptide

ET

Endotracheal tube

FiO2

Fraction of inspired oxygen

GCS

Glasgow coma scale

ICU

Intensive care unit

MAP

Mean arterial pressure

MOF

Multiple organ failure

MV

Mechanical ventilation

P/F

Oxygen arterial pressure/fraction of oxygen inspired

PEEP

Positive end-expiratory pressure

PEF

Peak expiratory flow

PSV

Pressure support ventilation

RSBI

Rapid shallow breathing index

SBT

Spontaneous breathing trial

Vt

Tidal volume

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Maria Vargas
    • 1
    Email author
  • Giuseppe Servillo
    • 1
  • Aniello Acampora
    • 1
  1. 1.Department of Neurosciences, Reproductive and Odontostomatological SciencesUniversity of Naples “Federico II”NaplesItaly

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