PICU Ventilator Weaning — Extubation Readiness Assessment — Clinical Pathway: ICU

Ventilator Weaning Clinical Pathway — PICU

Extubation Readiness Assessment

  • Test of the child’s ability to support spontaneous breathing with minimal positive pressure assistance.
  • Goal to reduce risk for re-intubation.
  • This assessment should be performed in children with expected short-term intubation for overnight postoperative care, procedural sedation, or short term intubations for airway protection and monitoring (e.g., seizures).
  • Before performing the assessment, ensure child’s sedation has been weaned appropriately and SBS = 0. See PICU Sedation Weaning Pathway for guidance.
  • Assessment typically performed on CPAP/PS. Providers may individualize settings based on clinical situation.

Components of Extubation Readiness Assessment

  • Adequate respiratory drive
  • Spontaneous breathing
  • Cough/gag present
  • SBS = 0
  • Airway bundle completed (for potential reintubation)
  • Ability to manage secretions