mac extubation?

[jean]

hi, i just want to ask : is it true if there is such thing as MAC extubation that we can use as our guideline for performing deep extubation? if there's such thing like that, where could i learn about this? please help...thx u:)

[jafo1964]

There are the following MAC values
MAC50
MAC 95
MAC BAR 50 & 95
MAC EI 50 & 95
MAC AGE
And
MAC  AWAKE

SO there is no recommended MAC value for extubation because MAC awake seems to meet this criteria

MAC AWAKE (if my memory serves right) is defined as the end tidal concentration of an inhalational agent at  1 atm at which 50% of patients will

Wake up
Respond to oral commands
Open eyes to oral commands
Indicating recovery from effect of inhalational agents.
MAC AWAKE = 0.6 of MAC 50 valueBut it has been found that even at MAC awake values the co-ordination of the fine muscles of the pharyngolarynx may not be fully restored. SO although the patient may be awake , the ability to swallow and protect airway adequately may not be 100% and hence the risk
In clinical practice and end tidal  concentration of 0.2 MAC is preferred before shifting the patient out of OT irrespective of at what value you prefer to extubate them at.

Regs

[jean]

thx u, jafo1964...u have always been so helpful ..i'll try to remember that :)thx