Ventilator weaning can be a challenging process, and only with careful assessment can it be successfully accomplished. Ventilator weaning rehab is the end of the process.
When is a patient ready for ventilator weaning?
It can be quite tricky to determine when a patient is ready for ventilator weaning, and there are several methods.
One method that doctors use is taking the patient off of the ventilator for a half an hour, with all of the necessary equipment still there for safety, and seeing how the patient does. If he breathes well, they can remove the ventilator. If not, they will re-intubate him for the time being. So long as it appears that he might be ready, they can try again every day until he breathes well on his own, and then extubate him.
However, often the patient can be weaned gradually from the ventilator, getting less and less support from the machine until he is completely able to breathe on his own.
“Wean” is not necessarily the accurate word, even though it’s the terms used here, because it implies a gradual removal, whereas ventilator weaning can also be instantaneous.
Even from the outset, as soon as the patient is connected to mechanical ventilation, the goal is to remove him as soon as possible. Prolonged connection to mechanical ventilation is associated with negative outcomes, including lung injury, pneumonia, and increased mortality. In fact, the longer the intubation, the higher the mortality rate. If the patient can breathe on his own the first time they attempt it, it’s called a simple weaning. If he can within 7 days, it’s called a difficult weaning. If it takes longer, it’s called prolonged.
If the weaning is either premature or too late, there are increased mortality rates. For this reason, doctors are urged to make the assessment based on clinical guidelines rather than personal judgement, even when using a clinical basis.
Ventilator weaning rehab
As soon as a patient is extubated, he needs to be continuously monitored to check for signs of sepsis, cardiac arrhythmia, or other problems. Blood pressure needs to be taken every few hours, and breathing needs to be carefully watched.
It’s ideal to try ventilator weaning in the morning, and if successful, to continue into the night.
Patients need to remain in a facility for ventilator weaning rehab for several days after weaning so the patient can recover and feel healthy enough to transition back to regular breathing.
In a facility, as opposed to a hospital setting, the patient can rest up in a comfortable environment with a fully dedicated and supportive staff, while being attended to 24/7 in case of medical emergency. He will have therapy to help with skills that he has lost and the ability to partake of facility activities at other times.
At the Alameda Center, we have everything you need for a pleasant and comfortable ventilator weaning rehab experience.