The first requisite for discontinuing ventilator
support is the improvement or resolution of the
underlying cause of respiratory failure and any
related complication. At that point, once the gas
exchange is adequate with low positive endexpiratory
pressure and low fraction of inspired
oxygen, hemodynamics is stable and the respiratory
drive to initiate spontaneous breaths is maintained
or re-established, the patient is usually ready for
withdrawal of ventilation and extubation.