Open Heart Rapid Wean Protocol

1
Respiratory Care
Open Heart Rapid Extubation Protocol
Open Heart patient received form OR
Patient placed on Vent
Settings ordered by Anesthesiologist
Mode SIMV Rate 10-12 FIO2 100 Vt 7-12
ml/Kg PEEP 5cmH20
PSV Level ETT tube size 7.0 10cmH20 7.5
8cmH20 8.0 6cmH20
Draw ABG 20 minutes after arrival and
placement on ventilator
Tritrate FIO2 to maintain SaO2 gt 95
is patient exhibiting adverse response to weaning
Return pt to Baseline, 30 mins - place on SIMV 4
YES
NO
NO
Is patient pH gt7.35, HCO3 gt 18 RR gt 15, TV gt
5-6ml/Kg Pt. able to hold head for 5 seconds
Obtain approval from ICU resident or Anesthesia
Staff to extube, place pt on 50 v-mask
YES
Tritrate FIO2 to maintain SaO2 gt 95 place on NC
when indicated
Revised 14 Nov 96 Michael G. Winter, RRT