Extubation Outcome after Spontaneous Breathing Trials with strongTstrong.pdfVIP

Extubation Outcome after Spontaneous Breathing Trials with T-Tube or Pressure Support Ventilation ANDRÉS ESTEBAN, INMACULADA ALÍA, FEDERICO GORDO, RAFAEL FERNÁNDEZ, JOSÉ F. SOLSONA, INMACULADA VALLVERDÚ, SANTIAGO MACÍAS, JOSÉ M. ALLEGUE, JESÚS BLANCO, DEMETRIO CARRIEDO, MIGUEL LEÓN, MIGUEL A. de la CAL, FRANCISCO TABOADA, JUAN GONZALEZ de VELASCO, EUGENIO PALAZÓN, FRANCISCO CARRIZOSA, ROSER TOMÁS, JOSÉ SUAREZ, and ROSANNE S. GOLDWASSER for the Spanish Lung Failure Collaborative Group From the Hospital Universitario de Getafe, Madrid; Hospital Parc Taulí, Sabadell; Hospital del Mar, Barcelona; Hospital Santa Creu i San Pau, Barcelona; Hospital General, Segovia; Hospital Santa María del Rosell, Cartagena; Hospital del Rio Hortega, Valladolid; Complejo Hospitalario, León; Hospital Arnau de Vilanova, Lleida; Hospital Central de Asturias, Oviedo; Hospital Josep Trueta, Gerona; Hospital Universitario, Murcia; Hospital de la Seguridad Social, Jerez; Hospital Hermanos Trias i Pujol, Badalona; Hospital Severo Ochoa, Leganés, Spain; and Hospital Clementino Fraga Filho, Rio de Janeiro, Brasil A 2-h T-tube trial of spontaneous breathing was used in selecting patients ready for extubation and discontinuation of mechanical ventilation. However, some doubt remains as to whether it is the most appropriate method of performing a spontaneous breathing trial. We carried out a prospective, ran- domized, multicenter study involving patients who had received mechanical ventilation for more than 48 h and who were considered by their physicians to be ready for weaning according to clinical criteria and standard weaning parameters. Patients were randomly assigned to undergo a 2-h trial of spontaneous breathing in one of two ways: with a T-tube system or with pressure support ventilation