Nursing ventilator withdrawal application.doc

 PAGE \* MERGEFORMAT 7 Nursing ventilator withdrawal application Study: LI Chun, Xie Bizhen, Zhang Youfang [Keywords:] ventilator withdrawal; nursing intervention Ventilator time varies with the patient’s condition, ranging from a few hours, may be a few more months or years. The establishment of artificial airway for too long, not only increase the pain, but also affect the recovery of lung function. In addition artificial airway continuing to establish an open airway, but also impede the ability of active sputum, increased chance of lung infections and means. How right to withdraw ventilator, to avoid the inconvenience of ventilator and pain, reduce complications as much as possible is very important. 1 ventilator withdrawal of standards and determine the success or failure Weaning 1.1 standard [1] (1) underlying disease or trauma has been stable or improved; (2) the stability of cardiovascular function, cardiac indexgt; 2L (min m2); (3) respiratory mechanics: respiratory rate lt;25 times / min, spontaneous breathing tidal volumegt; 5ml/Kg, maximum inspiratory pressuregt;-20cmH2O (1cmH2O = 0.098kPa); (4) oxygenation status indicators: arterial oxygen tension (PaO2)gt; 8.0kPa, alveolar - arterial oxygen difference (A-AdO2) lt;40kPa; (5) ventilation conditions: arterial carbon dioxide partial pressure (PaCO2) lt;8.0kPa, dead space volume and the ratio of total ventilation (VD / VT) lt;0.6. 1.2 The standard of success is not down 24 ~ 48h respiratory distress, the patient subjectively feel comfortable, heart rate, no significant increase in respiratory, blood gas analysis of inspection without acidosis and hypoxemia [2]. 1.3 The failure of standard mechanical ventilation more than 72h and failed to stop or shutdown not sustain spontaneous breathing after 24h, respiratory distress, respiratory rategt; 30 to 35 times / min, heart rategt; 120 beats / min or an increase of 20 times / min [ 3]. Arterial oxygen saturation lt;0.09, irritability, s