Table 3
Causes of weaning and extubation failure
| Increased respiratory load | Decreased respiratory capacity |
| Increased elastic load | Decreased respiratory drive |
| Unresolved lung disease | Sedation |
| Secondary pneumonia | CNS infection |
| Left to right shunt (PDA) | PVH/PVL |
| Abdominal distension | Hypocapnoea/alkalosis |
| Hyperinflated lungs | |
| Increased resistive load | Muscular dysfunction |
| Thick/copious airway secretions | Muscular catabolism and weakness (malnutrition) |
| Narrow/occluded endotracheal tube | Severe electrolyte disturbances |
| Upper airway obstruction | Chronic pulmonary hyperinflation (BPD) |
| Increased minute ventilation | Neuromuscular disorders |
| Pain and irritability | Diaphragmatic dysfunction |
| Sepsis/hyperthermia | Prolonged neuromuscular blockage (in renal failure, |
| Metabolic acidosis | concomitant use of aminoglycoside and phenobarbitone) |
| Myotonic dystrophy | |
| Cervical spinal injury | |
-
BPD, bronchopulmonary dysplasia; CNS, central nervous system; PDA, patent ductus arteriosus; PVH, periventricular haemorrhage; PVL periventricular leukomalacia.
