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Anaesthesia Miscellaneous 1d17ce39

A 53-year-old woman has been intubated for several days after sustaining a right pulmonary contusion after a motor vehicle collision as well as multiple rib fractures. Which of the following is a reasonable indication to attempt extubation?

A
Negative inspiratory force (NIF) of -15 cm H2O
B
PO2 of 60 mm Hg while breathing 30% inspired FiO2 with a positive end-expiratory pressure (PEEP) of 10 cm H2O
C
Spontaneous respiratory rate of 35 breaths per minute
D
A rapid shallow breathing index of 80
High-Yield Explanation
There are multiple predictors that have been used to assess readiness for extubation. No single parameter is 100% predictive; attempted extubation should be based on correction of the underlying pathology, clinical status and hemodynamic stability, and a combination of the following parameters. The rapid shallow breathing index is the ratio of the respiratory rate to tidal volume. There is evidence to suggest that an index between 60 and 105 predicts successful extubation. The negative inspiratory force should be at least greater than -20 cm H2O. The patient should be weaned to 5 cm H2O PEEP before attempting extubation. The minute ventilation, which is the product of the tidal volume and respiratory rate, should be less than 10 L/min. The spontaneous respiratory rate should also be below 20 breaths per minute

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