Pressure-Support Ventilation vs T-Piece During Spontaneous Breathing Trials Before Extubation Among Patients at High Risk of Extubation Failure: A Post-Hoc Analysis of a Clinical Trial.
ICU
airway extubation
mechanical ventilation
ventilator weaning
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
31
12
2019
revised:
01
04
2020
accepted:
20
04
2020
pubmed:
23
5
2020
medline:
4
6
2021
entrez:
23
5
2020
Statut:
ppublish
Résumé
Spontaneous breathing trial (SBT) using a T-piece remains the most frequently performed trial before extubation in ICUs. We aimed at determining whether initial SBT using pressure-support ventilation (PSV) could increase successful extubation rates among patients at high risk of extubation failure. Post hoc analysis of a multicenter trial focusing on reintubation in patients at high-risk of extubation failure. The initial SBT was performed using PSV or T-piece according to the physician/center decision. The primary outcome was the proportion of patients successfully extubated 72 hours after initial SBT, that is, extubated after initial SBT and not reintubated within the following 72 hours. Among the 641 patients included in the original study, initial SBT was performed using PSV (7.0 cm H In patients at high risk of extubation failure in the ICU, performing an initial SBT using PSV may hasten extubation without an increased risk of reintubation.
Sections du résumé
BACKGROUND
Spontaneous breathing trial (SBT) using a T-piece remains the most frequently performed trial before extubation in ICUs.
RESEARCH QUESTION
We aimed at determining whether initial SBT using pressure-support ventilation (PSV) could increase successful extubation rates among patients at high risk of extubation failure.
STUDY DESIGN AND METHODS
Post hoc analysis of a multicenter trial focusing on reintubation in patients at high-risk of extubation failure. The initial SBT was performed using PSV or T-piece according to the physician/center decision. The primary outcome was the proportion of patients successfully extubated 72 hours after initial SBT, that is, extubated after initial SBT and not reintubated within the following 72 hours.
RESULTS
Among the 641 patients included in the original study, initial SBT was performed using PSV (7.0 cm H
INTERPRETATION
In patients at high risk of extubation failure in the ICU, performing an initial SBT using PSV may hasten extubation without an increased risk of reintubation.
Identifiants
pubmed: 32439503
pii: S0012-3692(20)31401-X
doi: 10.1016/j.chest.2020.04.053
pii:
doi:
Types de publication
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1446-1455Investigateurs
Florence Boissier
(F)
Delphine Chatellier
(D)
Céline Deletage
(C)
Carole Guignon
(C)
Florent Joly
(F)
Morgane Olivry
(M)
Anne Veinstein
(A)
Dalila Benzekri-Lefevre
(D)
Thierry Boulain
(T)
Grégoire Muller
(G)
Yves Le Tulzo
(Y)
Jean-Marc Tadié
(JM)
Adel Maamar
(A)
Suela Demiri
(S)
Julien Mayaux
(J)
Maxens Decavèle
(M)
Lila Bouadma
(L)
Claire Dupuis
(C)
Pierre Asfar
(P)
Marc Pierrot
(M)
Gaëtan Béduneau
(G)
Déborah Boyer
(D)
Benjamin Delmas
(B)
Bérénice Puech
(B)
Konstantinos Bachoumas
(K)
Edouard Soum
(E)
Séverin Cabasson
(S)
Marie-Anne Hoppe
(MA)
Saad Nseir
(S)
Olivier Pouly
(O)
Gaël Bourdin
(G)
Sylvène Rosselli
(S)
Anthony Le Meur
(A)
Charlotte Garret
(C)
Maelle Martin
(M)
Guillaume Berquier
(G)
Abirami Thiagarajah
(A)
Guillaume Carteaux
(G)
Armand Mekontso-Dessap
(A)
Antoine Poidevin
(A)
Anne-Florence Dureau
(AF)
Marie-Ange Azais
(MA)
Gwenhaël Colin
(G)
Emmanuelle Mercier
(E)
Marlène Morisseau
(M)
Caroline Sabatier
(C)
Walter Picard
(W)
Marc Gainnier
(M)
Thi-My-Hue Nguyen
(TM)
Gwenaël Prat
(G)
Carole Schwebel
(C)
Matthieu Buscot
(M)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.