Burns et al reported the Burns Wean Assessment Program (BWAP) for evaluating a patient for weaning. The second part of the program is a respiratory assessment. The authors are from the University of Virginia.
Respiratory assessment:
(1) spontaneous respiratory rate < 25 per minute without dyspnea (eupneic respiratory rate and pattern)
(2) absence of rhonchi, rales and wheezing (adventitious breath sounds)
(3) secretions thin and minimal
(4) absence of neuromuscular disease and deformity
(5) absence of abdominal distention, obesity and ascites
(6) oral endotracheal tube >= 7.5 or tracheal tube >= 6.5
(7) cough and swallow reflexes adequate
(8) negative inspiratory pressure <= 20 cm H2O
(9) positive expiratory pressure >= 30 cm H2O
(10) spontaneous tidal volume > 5 mL per kg
(11) vital capacity > 10-15 mL per kg
(12) arterial pH 7.30 to 7.45
(13) PaCO2 approximately 40 mm Hg with minute ventilation < 10 L/min
(14) PaO2 > 60 mm Hg with FIO2 < 40%
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Response
|
Points
|
|
yes
|
1
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|
no
|
0
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unknown
|
0
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total subscore for respiratory assessment =
= SUM(points for all 14 items)
Interpretation:
• minimum subscore: 0
• maximum subscore: 14
• The higher the subscore the better.
