A patient may be discharged for long-term mechanical ventilation at home or an alternate community setting if clinically stable. The American College of Chest Physicians have developed criteria for identifying patients for whom such care is practicable.



(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



• Item 10 is from Heuer and Scanlan.


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