A 62-year-old man on ICU has a tracheostomy and is on a weaning programme. He is currently tolerating 12 hours off the ventilator on a T-piece during ...

Question

A 62-year-old man on ICU has a tracheostomy and is on a weaning programme. He is currently tolerating 12 hours off the ventilator on a T-piece during the day but requires ventilatory support overnight. He has been in ICU for 35 days. What classification of weaning describes this patient, and what is the next step?

Accepted Answer

Prolonged weaning - the patient has been weaning for >7 days after the first SBT; continue progressive T-piece extension, optimise nutrition (protein 1.3 g/kg/day), physiotherapy for respiratory muscle reconditioning, treat any reversible factors (cardiac, psychological, endocrine), and plan for step-down to a specialist weaning unit if ICU discharge criteria are otherwise met

Answer

Simple weaning - extubate immediately

Answer

Difficult weaning - reduce support immediately

Answer

The patient will never wean - convert to palliative care

Answer

No classification exists for weaning

uk-fficm MCQ (SBA): Prolonged Weaning Management