I have a question for the group.
Patient's always come to us from the OR on 100% Fi02, a rate, a tidal volume tailored to them, ps 10, peep 5. When we wean patient's from the vent on our CT unit, the final settings on the vent just prior to extubation are usually 35-40% Fi02, pressure support of 10, and PEEP of 5.
When I recently had a relative in the hospital for a major surgery, the vent settings for him for quite a period of time before extubation included Fi02 only, no ps, no peep. His ETT was a size 9!! I've never seen a tube that big!
I'm just wondering what others do? Is peep routinely used in your setting? What about pressure support? Or what does your weaning protocol look like?
Feb 22, '05
It was an open AAA repair. I've just never seen such a huge tube before and I was actually kind of curious about no support other than 02 with the vent.
He was a smoker. I'm wondering if they thought that having the extra thoracic pressure of the peep in there with his already more than likely less-than-compliant lungs would make it hard to get him extubated.
I asked the RT and she said that all of their patients end up on just the Fi02 just prior to extubation. But no pressure support? I would think that it would AWFULLY hard to breathe and oxygenate through that tube without some support...like breathing through a straw.
Last edit by begalli on Feb 22, '05