Hi there!
Today’s article is about, “Quick Tip for Families
in Intensive Care: How to Wean My Dad Off the Ventilator, Inotropes/Vasopressors, and Dialysis?”
You may also watch the video here on our website https://intensivecarehotline.com/ventilation/quick-tip-for-families-in-intensive-care-how-to-wean-my-dad-off-the-ventilator-inotropes-vasopressors-and-dialysis/ or you can continue reading the article below.
Quick Tip for Families in Intensive Care: How to Wean My Dad Off the Ventilator, Inotropes/Vasopressors, and Dialysis?
Hi, it’s Patrik Hutzel from
intensivecarehotline.com with another quick tip for families in intensive care.
So, today’s tip is about a question that we had from a client recently who has their loved one in intensive care for long periods of time. They’re asking, “How can they clear the pneumonia for their dad in ICU? How can they wean off the inotropes and the vasopressors, which are considered life support in
intensive care? How can they clear the kidney failure or improve the kidney failure, and how can they wean him off the ventilator?”
That’s a question that many families in intensive care have and let’s go through them one at a time.
One way to clear infection and pneumonia is with antibiotics, but also with ventilation therapy. In this case, the client has a ventilator and a tracheostomy. So, that is one way to clear the infection. It’s also important that you do regular pressure area care so that collapsed parts of the lungs are elevated. Sometimes it helps head up or head down, and obviously, the right antibiotics, assuming it’s a
bacterial infection or the right antiviral medication, if it’s a virus or the right antifungal medications, if it’s a fungal infection. So. that’s number one.
If the infection then comes down, that’s also often a way to go down with the inotropes and vasopressors, such as norepinephrine, noradrenaline, epinephrine, vasopressin, and a few others because they are considered life support as
well.
Now, other ways to get vasopressor or inotrope support down are to look at blood results. For example, if hemoglobin is low, hemoglobin is the red blood cells, then a
blood transfusion might also help to get inotropes and vasopressor support down.
So, there’s a number of things you need to look at, which is why I’m always saying, when someone is in intensive care, it’s like piecing together a puzzle. There’s dozens of things happening simultaneously, and unless you understand how the body system works and unless you understand all the moving pieces, you have no
idea what you’re looking for.
I have worked in critical care for nearly 25 years in three 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 intensivehotline.com.
We’ve been saving many lives, and you can verify that by looking at our testimonial section at intensivecarehotline.com, or you click on our podcast section, where we have done client interviews.
Coming back to our questions today. So, how do you then manage kidney failure? So, this particular client’s dad is on CRRT (Continuous Renal Replacement Therapy), also known as hemofiltration. It often takes time for the kidneys to heal. Sometimes the kidneys kick back in again and will start making urine, and sometimes they don’t. It’s not a one size fits all. Unfortunately, some
patients, after intensive care, require dialysis for the rest of their lives.
So, it’s also intensive care, you have to be patient. Unfortunately, there are sometimes no magic tricks, and it’s just time that will help to get people from point A to point B and improve their condition. My advice is to talk to the renal specialist as well here.
Next, how do you wean then your dad off the ventilator and the tracheostomy? Obviously, the infection needs to be cleared first. Inotropes and vasopressor support needs to come down or that needs to be stopped altogether. Then, you can start focusing on ventilation weaning. In this particular case, our client’s dad
was already making headway with weaning off the ventilator. They were already making progress but then the infection in.
That’s also another thing in intensive care, it’s two steps forward, one step back most of the time. So, patience is critical here, and I also know that intensive care teams are often not very patient. They work on their own timelines, which are often based on bed management
strategy. They’re based on their finances. They’re not often based on the best interest of the patient.
If they think they’re losing money on a patient, then you often get the doom and gloom and you get told, “Oh, well, it’s not in the best interest for your family member to live. It’s in the best interest for them to die.” I mean, that’s just bollocks. That’s just a whole lot of nonsense. Then you
get the doom and gloom talk when the finances no longer makes sense for the ICU, when they look at the business case, which is very demoralizing, and it’s very sad. But at least you now know the forces at play, and you can counteract them. That’s what we’ve been doing from Day 1 here with very good results.
Once the infection is clear, once inotropes have been weaned then they need to start
mobilizing your loved ones. They need to start mobilizing them and have a weaning plan. There are so many clients we are working with and have worked with over the years that the ICUs have no weaning plan. They’re just
dabbling around, and there needs to be a weaning plan. There needs to be a method in going from point A to point B. All the successful weaning cases that I’ve seen over the years all starts with a weaning plan, and then following through on that weaning plan.
Of course, if it doesn’t work making changes, like I said, it’s often two steps forward, one step back. But if there is no weaning plan, your
loved one stands a very low chance to ever be weaned off that ventilator. So, I hope that helps.
Because we’re getting so many questions for families in intensive care every day, that’s why we created a membership for families of critically ill patients in intensive care at intensivecarehotline.com. You can click on the membership link, and you can become a member there or you go to intensivecaresupport.org directly. In the membership, you have access to my team and to me, 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 recorded and written. Those videos and e-books will help you this incredibly difficult to steer this incredibly difficult territory that is intensive care. It will help you to make informed decisions, have peace of mind, control, power, influence, making sure your loved one gets best care and treatment.
Remember when you have a loved one critically ill in intensive care, it’s a once in a lifetime situation that you can’t afford to get wrong. If you do get it wrong, many families contact us 12 months later after they’ve lost a loved one in intensive care, and then they’re starting to do their research.
Then, all of a sudden,
they realize, “Oh, they’ve gone down the wrong path.” But now it’s too late, so you can’t afford to get it wrong.
I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. But I also talk to doctors and nurses directly. I ask all the questions that you haven’t even considered asking when talking to doctors and nurses directly. Once again, I’ll make sure you make informed decisions, have peace of mind, control, power, and influence all leading to your loved one getting best care and treatment. I also represent you in
family meetings with intensive care teams.
We also offer medical record reviews in real time so that you can get a second opinion in real time. We also offer medical
record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.
All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to support@intensivecarehotline.com with your questions.
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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 for now.
