How to extube power point presentation

គ្រាន់ជាគំនិតខ្លះៗសំរាប់ការថែទាំ

1. Extubation

2. Ventilation classification 1- Simple 2- Difficult (2-7day) 3- Prolonged >7day

3. Weaning failure Pass a spontaneous-breathing trial (failure) or re-intubation within 48hour following extubation . Predicting success is important to reduce rates of Re-intubation.

4. Wean Screen (General) Lung disease is stable/resoling Low Fio 2 (<50%) and PEEP (<5-8mmHg) requirement Hemodynamic stability (little to no inopressois Able to in spontaneous breaths (good neuromuscular function)

5. PASS All to be assessed for extubation

6. Optimize Respiratory muscle power Nutrition Avoid neuromuculare blocking drugs, decreas steroid use and other contributors to critcal illness induce weakness. Encorrage spontaneous breathing but avoid extubation .

7. Optimize Respiratory muscle power Normal electrolytes Normal FRC Physiotherapy

8. Decrease Respiratory work Sit up Decrease respiratory demand Decrease CO2 Correct metabolic acidosis Decrease resistance Increase compliance

9. Optimize ventilator drive Stop sedation Consider cause from the brain to the neuromuscular function

10. Increase oxygenation and carrying capacity Sit up and avoid atelectasis Correct anemia Correct acid-base disturbance

11. Predictors of weaning failure Advanced age Prolonged mechanical ventilation COPD Increased minute ventilation Positive fluid balance

12. យើងសង្ឃឹមថាការបង្ហាញនេះនឹងផ្តល់ជាបទពិសោធថ្មីដើម្បី ជាជំនួយក្នុងការថែទាំ & ព្យាបាលកាន់តែមានគុណភាព។ សូម អគុណ!