The ventilator patient in the ICU must meet all of the following criteria to enter the ventilator-weaning protocol:
Hemodynamic stability
Heart rate between 50 and 120 beats/min
Blood pressure between 90 and 180 mm Hg
No pressors
SpO2 90%
FIO2 0.50
PEEP 8 cm H2O
Spontaneously breathing
Tidal volume 5 mL/kg on pressure support of zero and PEEP of zero
Negative inspiratory force less than 20 cm H2O on pressure support of zero and PEEP of zero
Rapid shallow breathing index 105 on pressure support of zero and PEEP of zero
Minute ventilation 15 L/min on pressure support of zero and PEEP of zero
If all the above parameters are within goal, proceed to spontaneous breathing trial.
If any parameter does not meet the goal, leave the patient on the prior ventilation mode and notify the physician.