Weaning patients from maximum ventilator support usually involves:

D. Weaning FIO 2 first, PEEP second, and ventilator rate third.

DISCUSSION: When the inspired oxygen concentration is greater than 60% for more than 24 to 28 hours, the risk of oxygen toxicity increases. PEEP is usually weaned to physiologic levels (i.e., 5 to 7 cm. H 2O) before weaning either rate or tidal volumes. Generally, the optimal tidal volume to achieve alveolar recruitment is selected and usually is not decreased unless peak airway pressures increase. If decreases in ventilatory rate are not tolerated, airway pressure support can be added.