OBJECTIVE: To investigate the possibility of successful extubation performing a spontaneous breathing trial (SBT) in pressure support ventilation (PSV) with target durations of 30 and 120 min. DESIGN AND SETTING: Prospective and randomized study in two medical-surgical adult intensive care units. PATIENTS AND PARTICIPANTS: 98 adult patients supported by mechanical ventilation for at least 48 h and considered ready for a weaning trial. INTERVENTIONS: An SBT conducted in PSV with 7 cmH(2)O and patients randomly assigned to two groups with target durations of 30- and 120-min. MEASUREMENTS AND RESULTS: In the 30-min group 43 patients (93%) tolerated the SBT and were extubated while 4 (9%) needed reintubation within 48 h; in the 120-min group 46 patients (88%) successfully completed the trial and were extubated while 2 (4%) were reintubated. ICU mortality in the groups with short and long periods was 6% and 4%, and in-hospital mortality 20% and 17%, respectively. Those successful in the 30- and 120-min groups had similar length of ICU stay (6 and 7 days, respectively) and in-hospital length of stay (20 and 25 days, respectively). Compared to the successfully extubated, the reintubated patients had significantly higher length of ICU stay and mortality (17 vs. 6 days and 33 vs. 3.6%, respectively). CONCLUSIONS: An SBT with PSV of 7 cmH(2)O lasting 30 min is equally effective in recognizing the successfully extubated patients as a 120-min trial.
RCT Entities:
OBJECTIVE: To investigate the possibility of successful extubation performing a spontaneous breathing trial (SBT) in pressure support ventilation (PSV) with target durations of 30 and 120 min. DESIGN AND SETTING: Prospective and randomized study in two medical-surgical adult intensive care units. PATIENTS AND PARTICIPANTS: 98 adult patients supported by mechanical ventilation for at least 48 h and considered ready for a weaning trial. INTERVENTIONS: An SBT conducted in PSV with 7 cmH(2)O and patients randomly assigned to two groups with target durations of 30- and 120-min. MEASUREMENTS AND RESULTS: In the 30-min group 43 patients (93%) tolerated the SBT and were extubated while 4 (9%) needed reintubation within 48 h; in the 120-min group 46 patients (88%) successfully completed the trial and were extubated while 2 (4%) were reintubated. ICU mortality in the groups with short and long periods was 6% and 4%, and in-hospital mortality 20% and 17%, respectively. Those successful in the 30- and 120-min groups had similar length of ICU stay (6 and 7 days, respectively) and in-hospital length of stay (20 and 25 days, respectively). Compared to the successfully extubated, the reintubated patients had significantly higher length of ICU stay and mortality (17 vs. 6 days and 33 vs. 3.6%, respectively). CONCLUSIONS: An SBT with PSV of 7 cmH(2)O lasting 30 min is equally effective in recognizing the successfully extubated patients as a 120-min trial.
Authors: Michael J Banner; Neil R Euliano; A Daniel Martin; Nawar Al-Rawas; A Joseph Layon; Andrea Gabrielli Journal: Intensive Care Med Date: 2011-11-24 Impact factor: 17.440
Authors: Alexis Ferré; Max Guillot; Daniel Lichtenstein; Gilbert Mezière; Christian Richard; Jean-Louis Teboul; Xavier Monnet Journal: Intensive Care Med Date: 2019-03-12 Impact factor: 17.440
Authors: Magdaline T Ladeira; Flávia M R Vital; Régis B Andriolo; Brenda N G Andriolo; Alvaro N Atallah; Maria S Peccin Journal: Cochrane Database Syst Rev Date: 2014-05-27
Authors: Carles Subirà; Gonzalo Hernández; Antònia Vázquez; Raquel Rodríguez-García; Alejandro González-Castro; Carolina García; Olga Rubio; Lara Ventura; Alexandra López; Maria-Carmen de la Torre; Elena Keough; Vanesa Arauzo; Cecilia Hermosa; Carmen Sánchez; Ana Tizón; Eva Tenza; César Laborda; Sara Cabañes; Victoria Lacueva; Maria Del Mar Fernández; Anna Arnau; Rafael Fernández Journal: JAMA Date: 2019-06-11 Impact factor: 56.272
Authors: Andreas Perren; Marco Previsdomini; Michael Llamas; Bernard Cerutti; Sandor Györik; Giorgio Merlani; Philippe Jolliet Journal: Intensive Care Med Date: 2010-08-06 Impact factor: 17.440
Authors: K Reinhart; F Brunkhorst; H Bone; H Gerlach; M Gründling; G Kreymann; P Kujath; G Marggraf; K Mayer; A Meier-Hellmann; C Peckelsen; C Putensen; M Quintel; M Ragaller; R Rossaint; F Stüber; N Weiler; T Welte; K Werdan Journal: Internist (Berl) Date: 2006-04 Impact factor: 0.743