Curriculum · Respiratory
Extubation readiness and the spontaneous breathing trial
What it is
Extubation readiness is the short list of criteria checked before a spontaneous breathing trial, and it asks three things: first, is the pH high enough; second, is oxygenation adequate on minimal support; and third, are inspiratory effort and mental alertness intact enough to protect the airway.
How it is diagnosed
The criteria for extubating readiness are three. The first is a pH above 7.25. The second is adequate oxygenation on minimal support, that is FiO2 < 40 and PEEP < 5. The third is intact inspiratory effort and mental alertness to protect the airway. Each part stands on its own. A pH that is not above 7.25 fails the first. A patient who still needs FiO2 of 40 or more, or PEEP of 5 or more, is not on minimal support. And a patient without intact inspiratory effort, or without mental alertness, cannot protect the airway, however good the other numbers look.