ICU病人困难脱机的原因及处理对策13 6571

rom mechanicalventilatorysupport. Haemoglobinmustalsobeoptimized >8g% >10g%withmyocardialischemia/cerebralischemiaFAILURETOWEANOFFVENTILATOR:CAUSES-2Neurological: -brainstemdysfunctionduetotrauma,hypoxiaor?infection,criticalillnesspolyneuropathy -anophosphorus?insecticidesFluidBalance: Positivecumulativefluidbalanceisassociatedwith?failuretoweanandanegativefluidbalancewas?essfulweaninginarecentstudy.Infection: anysepsisand/orrespiratoryinfectionshouldhave?resolvedFAILURETOWEANOFFVENTILATOR:?CAUSES-3Drugs -stopsedativesanddrugslikelytoimpair neuromuscularfunction. -giveantidotes(flumazenil,nalorphine,neostigmine) asindicatedElectrolytes-maintainnormalserumpotassiumand phosphorousAlkalosis -respiratory–don’tchasethePaCO2 -metabolic–reducebaseexcess(?acetazolamide)PaO2Endocrine-hypothyroidism