First Step: A Control Group Of Patients In The ICU, 62 Patients Undergoing Mechanical Ventilation Are More Than 24 Hours As Controls Are Evaluated. Inclusion Criteria Included Age 80-18 Years, Absence Of Neurological And Neuropsychiatric Diseases - Muscular, Use The Minimum Dose Of Sedative Drugs (Light Relaxation Time Scale As Palma And Cooke 18-15) And No Addiction Opium. Information Required By The Tables And The Questionnaire Attached Proposal, Will Be Collected From The Records Of Patients Hospitalized In The ICU. At This Stage, the Researcher Is Present Only As Observers. The Primary Criterion's For The Separation Of Eight Patients In This Group Are:
1 - The Start of Mechanical Ventilation On The Sides Or Dropped.
2-CT <38.5 0
3 - Hb ≥ 8 gr / Dl
4 Pao2 ≥ 60 mmhg –
5 - Sao2 ≥? With Fio2 ≤ 40%
6 - PEEP ≤ 8 Cmh2o
7 - F / TV ≤ 105
8 - Use the Minimum Dose Of Drugs Sedative Before Separation,
All Patients with PSV = 8-10 Cmh2o, PEEP = 5cmh2o, Fio2 <40% Were Ventilated According To The Physician, Patients Are Removed From The Device Under The SBT With A T-Piece With Are The Average Of 2 Hours. During The First Minutes before Separation with The ABG And Calculation, Cst, Rs, MV, Pao2 / Fio2 F / TV And ... Standard Index Of Separation: IWI = (Cst, Rs * Sao2) / (F / TV) Is Calculated. If There Are Favorable Conditions With Your Doctor, Extubation Is Performed. After Extubation, 48 Hours control Clinical Status Is Considered. Back To The Mechanical Ventilation For Patients With Medical Conditions That Are Completely Unaware Of The Study And The Index Is To Be Taken.
Second Stage: The Eight Criteria IWI Index Separation And Isolation Of Patients To Physicians And Nurses In Charge Of The Mechanical Ventilator, Is Taught. The Other 62 Patients According To Inclusion Criteria Are Enrolled. Contextual Information from The Records Of The Mining Sector And Will Be Recorded. 8 The Primary Criterion For The Separation To Be Evaluated In Patients On A Daily Basis. All Patients Before Separation, With Fio2 <40% PEEP = 5cmh2o, PSV = 8-10 Cmh2o, And They Were Ventilated During The First Minutes Before Separation With The ABG And Calculate F / TV, Cst, MV, Pao2 / Fio2.The IWI Index Is Calculated By The Medical Team In Case Of IWI ≥ 25Conditions, With The Doctor, Patients With T-Piece SBT With An Average Period Of 2 Hours To Start. If There Is An Effective Cough (Subjective Evaluation By The Research Team) And The Stability Condition (Assessed Objectively By The Glasgow Scale 4 Score And GCS), Is The Readiness For Extubation. After Extubation, The Patient Is Evaluated For 48 Hours. Third Stage: The Rate of Successful and Unsuccessful Isolation of the Mechanical Ventilator in the Two Groups Are Compared