T piece

So, you wean by taking off the vent to place on t piece? How does that work for you? We do cpap weans, that way we can give a little extra pressure support if we need to. We wean on to FiO2 that the pt is on, usually 50% or lower.

We use cpap to, but in some cases, we need to know if the patient can be without any "help" pressure. And so, we put him with t piece no more than 15-30 min.

Usually we do like this:

VC - SIMV+PS (reducing progressively the RR and PS) - CPAP and sometimes T piece trial.

Some patients we leave on the T-piece 6-8 hours prior to extubation. We do this to observe for fatigue . Of course we are doing continuous pulse ox monitoring. And the respiratory tech does final tests on pt, prior to agreeing to extubation. While on the t-piece , If the patient

slowly gets tired then we will reconnect to ventilator for overnight and

then T-piece again in the morning. Usually extubate about 2:00 in the afternoon. So, we have a clear idea before night shift that the patient is doing well and his respiratory status is stable.