My name is Patrik Hutzel from intensivecarehotline.com, where we help families of critically ill patients in intensive care, making informed decisions, have peace of mind, control, power, and influence, making sure your loved one always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

Today I want to talk about ICU failing ventilation weaning. Here’s what they’re not telling you.

Today I’m having an email from one of our clients, Tom, who has the following email. He says,

“Hi Patrik,

I was observing all but a few of the ICUs weaning therapy sessions and none of them achieved the goal. They reduced the air assist below 10 in order to wean my mother off the ventilator. This was for the past 7 days when the ICU nurse did so yesterday. My mother breathed for 2.5 hours with oxygen the same as in the room. I confronted them this morning and they admitted that they had never been below 10 before except to test mom at 5. I told them going from 10 to 5 and expecting a mother to perform at 5 without any weaning at progressively lower pressures, 8, 7 and 6, is doomed to failure. Their response was that this Sunday morning before waking up, they performed spontaneous breathing trials, which she failed 5 times, so there never was any reason to wean to 5. I have asked for mom’s respiratory records for the past week of being off sedatives to see how often she stopped breathing on her own. I will have the records tomorrow. If we ask you to spend more effort on this, is it still worthwhile if she stops breathing when asleep? I do want you to spend more time on this case, if there is hope. She has had a recent worsening of the existing stroke injuries that the medical staff say is likely why she now stops breathing. Is this true?

If your loved one is stuck in intensive care on a ventilator in a similar situation and the ICU keeps saying they’re failing weaning trials or they can’t breathe on their own, you need to hear this, and make sure you subscribe to my YouTube channel, click the notification bell, click the like button and share the video with your friends and families and check out the links below for free resources at intensivecarehotline.com.

What’s really happening with weaning in ICU? Tom’s mother has been in ICU for over a week, and despite being awakened off sedation, they’ve never reduced her pressure support below 10, and that’s not proper weaning. A real weaning process needs to be gradual. Pressure support should be lowered step by step from 10 to 8, then 7, 6, 5. Doesn’t need to be any lower than that really. Jumping straight from 10 to 5 sets patients up for failure. It’s no wonder your mother failed these spontaneous breathing trials 5 times. They haven’t actually been preparing her respiratory muscles for success. Unfortunately, many ICUs either don’t have the expertise, the time, or the patience to do proper ventilator weaning. Also, you have never mentioned that your mom may or may not receive physical therapy or physiotherapy and breathing exercises, because that’s potentially a missing ingredient here.

Again, the biggest challenge for families in intensive care is that you don’t know what you don’t know. You don’t know what to look for, you don’t know what questions to ask, you don’t know your rights, and you don’t know how to manage doctors and nurses in intensive care.

Let’s look at the importance of medical records and transparency. Tom did the right thing. He asked for his mother’s respiratory and medical records. That’s the key step most families miss. You need access to all medical records at all times, ventilation settings, arterial blood gases, doctor’s notes, nurse’s notes, respiratory therapist’s notes, physiotherapists notes, and so forth. Without this crucial information, you can’t verify what’s really going on. When an ICU says they failed, you need to ask under what conditions, what’s leading up to that? What are they potentially not telling you? You need to find out if the notes match what they’re telling you. From all my extensive experience, I can tell you most ICUs do not even tell families half of what’s going on. When families and I get on a call with the doctors, I unravel things very quickly, and you will find out very quickly that they’re not even telling you half of what’s going on, because with all my knowledge about intensive care, I can ask questions that you haven’t even considered asking, but must be asked in situations like that.

At intensivecarehotline.com we help families in intensive care analyze those medical records, explain what’s actually really happening, and speak directly to the ICU team, changing the dynamics in your favor. You can book a consulting call with me or my team, and we can join family meetings with intensive care teams, ask the right questions, and advocate for your loved one to make sure best practice weaning is followed.

You’re also saying in your email, mom stops breathing when asleep. What does that really mean? Tom asked this critical question. His mother stops breathing when asleep, and the ICU claims it’s due to a worsening stroke. That may be partly true. Neurological injuries can impact the brain’s respiratory drive, but that doesn’t mean all hope is lost. Many patients with brain injuries or strokes can still be successfully weaned if given the right strategy, the right time and the right environment. Unfortunately, most ICUs are not set up for long-term ventilator weaning. That’s where Intensive Care at Home comes in, because weaning at home is a real solution.

At intensivecareathome.com, we provide home-based intensive care with critical care nurses 24/7. We specialize in long-term ventilation and tracheostomy weaning at home, where infection risks are much lower and the patient’s quality of life is by far superior compared to an ICU. We’ve helped many patients who were stuck in ICU finally weaned off the ventilator at home after the ICU had given up on them. If your loved one isn’t progressing in ICU, there are safe and proven alternatives outside of the hospital and ICU system that we can organize for you.

Let’s look at action steps here. Here’s what you need to do next if your loved one is in a similar situation. Number 1, request all medical records, ventilator settings, arterial blood gases results, progress notes, CT scans, MRI scans, chest X-rays, everything. Leave no stone unturned. The devil is in the detail. Book a call with us here at intensivecarehotline.com and we can review and discuss your case. Let us join a family meeting with the ICU team so we can advocate for evidence-based care. Have a look at intensivecareathome.com for long-term ventilation and weaning options at home.

Tom and everyone watching, don’t accept that your mother or your loved one can’t be weaned until you’ve had the right team advocate for you. Your ICU might not be telling you the full story, and without clinical expertise and second opinions on your side, you are at their mercy. Go to intensivecarehotline.com right now and book your free strategy call. Let us help you take back control, get the facts, and give your loved one the best chance of recovery. Like I said, if your loved one needs long-term ventilation with tracheostomy or weaning at home, check out intensivecareathome.com. We can help you make this transition safely and effectively.

I have worked in critical care nursing for 25 years in 3 different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy, because of our insights, and you can verify that on our testimonial section at intensivecarehotline.com and you can verify it on our intensivecarehotline.com podcast section where we have done client interviews. Because our advice is absolutely life-changing.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for, they don’t know what questions to ask, they don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care. That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets the best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. And I talk to you and your families directly. I handhold you through this once-in-a-lifetime situation that you simply cannot afford to get wrong. And when I talk to families directly, I also talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care. I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real-time. We also do medical record reviews after intensive care, in case you have unanswered questions, if you need closure or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com. If you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team 24 hours a day in the membership area and via email, and we answer all questions intensive care-related. In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded. And all of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment, always. And all of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

And if you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on a show and you will get notification from the YouTube Live if you are a subscriber to my YouTube channel or if you are a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care.

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