RT-07 · Initiation & Modification

Ventilator Weaning, Liberation & Extubation

Readiness criteria, the spontaneous breathing trial, the numbers that predict success, and how to recognize post-extubation failure early.

~22 min read3 concept sections·4 questions with rationale

What you'll be able to do

  • Apply objective readiness criteria before a weaning trial
  • Conduct and interpret a spontaneous breathing trial
  • Calculate and use the rapid shallow breathing index
  • Anticipate and manage post-extubation complications
Concept breakdown
01

Readiness before the trial

Liberation begins with the disease, not the ventilator. The cause of the failure must be improving.

  • Reversal of the underlying cause, hemodynamic stability on minimal vasopressors, and adequate mental status.
  • Oxygenation: PaO2/FiO2 >150–200 on FiO2 ≤0.40–0.50 and PEEP ≤5–8 cm H2O.
  • Ability to initiate an inspiratory effort and to protect the airway with an effective cough.
  • Secretions manageable — suctioning needed less often than roughly every 2 hours.
At the bedside

Extubation failure is usually an airway problem, not a lung problem. Judge the cough before the gas.

Practice quiz

Check yourself before you read the rationale.

Question 1 of 1

During an SBT, a patient breathes at 32/min with an average tidal volume of 250 mL. The RSBI and the interpretation are:

Practice questions

Answer first, then read why the distractors fail.

Question 1

During an SBT, a patient breathes at 32/min with an average tidal volume of 250 mL. The RSBI and the interpretation are:

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2 more concept sections, 3 more questions, and the exam-day playbook for this module.

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