Criteria:
(1) absence of all of the following while on the ventilator:
(1a) significant sustained dyspnea
(1b) severe dyspneic episodes
(1c) tachypnea
(2) acceptable arterial blood gas values on FIO2 <= 0.40
(3) psychologic stability
(4) absence of life-threatening cardiac dysfunction or arrhythmias
(5) not expected to require a major change in management that would require readmission to the hospital for the next month
(6) able to clear secretions
(7) presence of either:
(7a) a gag or cough reflex, or
(7b) a protected airway
(8) absence of significant aspiration
(9) presence of a tracheostomy rather than an oral or nasal tracheal (endotracheal) tube
(10) no PEEP or PEEP <= 10 cm H2O
Additional criteria for pediatric patients:
(1) absence of intercostal retractions
(2) showing growth and making developmental progress
where:
• Item 10 is from Heuer and Scanlan.
