Respirator weaning in COPD

[Vikingnurse]

I am working in an MICU in Oslo, Norway. We have a discussion going on with our doctors about respirator weaning in COPD patients. So far the usual way of weaning is reducing pressure support above PEEP, then PEEP and when the patient has reach a desired goal (ie. 5-7 in PEEP and 10-12 in PS above PEEP) we begin training with external C-PAP. We can find little or no litterature that describe differences between external C-PAP and internal C-PAP from the respirator.

Some argue that the flow from the external has possitive effect others argue that there is no difference, and it is only psychological to the doctors.

Do you have other ways/expirenses of weaning?

What if the patient gets too comfortable on the respirator? It's easy compared to before ventilatortreatment.

VikingNurse

[mags-rn]

There is one thing to keep in mind - A.P.R.V ventilation, and that ventilation is not curative form of science, but only a means of relief.