Which of the following reflects common extubation readiness criteria?

• A. Adequate oxygenation on low support (FiO2 ≤0.4–0.5, PEEP ≤5–8 cm H2O), stable hemodynamics, intact airway protection, and successful spontaneous breathing trial
• B. FiO2 ≤0.6 and PEEP ≤10 cm H2O
• C. Unstable hemodynamics
• D. Inability to perform spontaneous breathing trial

Answer: (A)

The main idea is recognizing what readiness looks like: a patient who can be taken off the ventilator and breathe safely on their own. The best answer describes adequate oxygenation with minimal support (low FiO2 and low PEEP), stable cardiovascular status, intact airway protection, and a successful spontaneous breathing trial. When FiO2 is kept around 0.4–0.5 and PEEP around 5–8 cm H2O, it shows the patient can maintain oxygenation without heavy ventilator help. Stable hemodynamics means no ongoing vasopressor needs or shock, which reduces the risk of instability after extubation. Intact airway protection indicates reliable coughing and gag reflexes to clear secretions and prevent aspiration. A positive spontaneous breathing trial demonstrates the patient can sustain breathing without full ventilatory support, confirming they can handle the transition. Conversely, higher oxygen or PEEP requirements, unstable hemodynamics, or an inability to perform an SBT suggest the patient is not yet ready for extubation.