Recognize
Reassess respiratory load, cardiac dysfunction, fluid overload, diaphragmatic weakness, sedation/delirium, infection, anemia, nutrition, electrolytes and airway/secretion burden rather than repeatedly performing identical SBTs.
procedures / devices
Repeated Failure to Liberate from Ventilation
Persistent ventilator dependence requiring a cause-based liberation and airway plan.
Act
Minimize unnecessary sedation, mobilize early and use an SBT strategy appropriate to the patient; extubation readiness also requires airway protection and secretion management.
Reassess
Reassess trajectory, organ support, competing diagnoses and failure of first-line therapy; escalate early when physiology is worsening.
Evidence status
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