Mechanical ventilation is initiated in patients who are acutely ill and many have chronic underlying health problems. In those with cardiac disease, weaning from mechanical ventilation can place an added stressor on an already distressed system. For that reason, we monitor patients closely during weaning from mechanical ventilation. There are standard parameters that are monitored. For example, vital signs, tidal volume, and mental status changes are all important determinants of the success or failure of a weaning trial. However, as Hammash and colleagues found in their research, measuring heart rate variability can be a significant predictor of dysrhythmias during weaning. When risk can be predicted and measured, interventions can be planned and implemented before negative consequences, such as myocardial ischemia, impaired myocardial contractility, and a decrease in cardiac index, occur.

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