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Factors that can lead to weaning failure due to the imbalance between ventilatory needs and respiratory capacity |
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| Factors that increase the load |
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| Increased resistive loads |
Increased chest wall elastic loads |
Increased lung elastic loads |
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| Bronchospasm |
Pleural effusion |
Hyperinflation (intrinsic positive end-expiratory pressure) |
| Airway edema, secretions |
Pneumothorax |
Alveolar oedema |
| Upper airway obstruction |
Flail chest |
Infection |
| Obstructive sleep apnea |
Obesity |
Atelectasis |
| Endotracheal tube kinking |
Ascites |
Interstitial inflammation and/or oedema |
| Secretions encrustation |
Abdominal distension |
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| Ventilatory circuit resistance |
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| Factors that result in decreased neuromuscular competence |
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| Decreased drive |
Muscle weakness |
Impaired neuromuscular transmission |
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| Drug overdose |
Electrolyte derangement |
Critical illness polyneuropathy |
| Brain-stem lesion |
Malnutrition |
Neuromuscular blockers |
| Sleep deprivation |
Myopathy |
Aminoglycosides |
| Hypothyroidism |
Hyperinflation |
Guillain-Barré syndrome |
| Starvation/malnutrition |
Drugs, corticosteroids |
Mysthenia gravis |
| Metabolic alkalosis |
Sepsis |
Phrenic nerve injury |
| Myotonic dystrophy |
Spinal cord lesion |
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*Positive test result is a value of rapid shallowbreathing index (f/VT) lower than 105 or 100; †negative testresult is a value of f/VT higher than 105 or 100. | ||
Alía and Esteban Critical Care 2000 4:72 doi:10.1186/cc660 |
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