What criterion best indicates readiness to wean from invasive ventilation in a neonate?

• A. Increased work of breathing and unstable vitals.
• B. Requirement for higher FiO2 despite ventilation.
• C. Stable oxygenation on lower FiO2 and PEEP with adequate spontaneous breathing and stable hemodynamics.
• D. Inability to maintain adequate gas exchange.

Answer: (C)

Readiness to wean from invasive ventilation occurs when the neonate can maintain adequate gas exchange with less support: oxygenation remains stable on a lower FiO2 and lower PEEP, there is adequate spontaneous breathing, and hemodynamics are stable. This combination shows the lungs are sufficiently functioning to handle decreased ventilator assistance without destabilizing the infant. If the baby requires higher oxygen levels despite ventilation, shows increased work of breathing with unstable vitals, or cannot maintain gas exchange, those are signs that readiness has not been reached.