Indications and criteria for extubation or decannulation of patients unable to sustain autonomous breathing

The patient is mentally competent, cooperative, and not using heavy sedation or narcotics

Supplemental oxygen therapy is avoided or minimized

SaO₂ is maintained above 95 percent by aggressive airway secretion elimination and assisted ventilation as necessary

Bulbar muscle function is sufficient so that aspiration of airway secretions does not cause O₂ desaturation below 95 percent

There is no history of substance abuse or uncontrollable seizures

Pulmonary compliance is adequate for noninvasive IPPV to provide normal alveolar ventilation at interface pressures under 40 cm H₂O

There are no conditions which interfere with the use of IPPV interfaces, ie, facial fractures, inadequate bite or neck rotation for mouthpiece entry, presence of a nasogastric tube or a beard that hampers airtight interface seal, etc

Graphic 64672 Version 2.0

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Indications and criteria for extubation or decannulation of patients unable to sustain autonomous breathing