Clinical Characteristics, Respiratory Functional Parameters, and Outcome of a Two-Hour T-Piece Trial in Patients Weaning from Mechanical Ventilation.

Vallverdú, I.; Calaf, Núria; Subirana, Mireia; A, Net; Benito, S.; Mancebo, Jordi

doi:10.1097/01823246-199910010-00011

Cited by 84 publications

(117 citation statements)

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“…Studies have shown that the majority of SBT failures occur within 30 min 236 237. Repeated failure of SBT should lead to consideration of other methods of weaning 238 239…”

Section: Weaning From Imvmentioning

confidence: 99%

BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults

Davidson

Banham

Elliott

et al. 2016

Thorax

312

303

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“…Studies have shown that the majority of SBT failures occur within 30 min 236 237. Repeated failure of SBT should lead to consideration of other methods of weaning 238 239…”

Section: Weaning From Imvmentioning

confidence: 99%

BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults

Davidson

Banham

Elliott

et al. 2016

Thorax

312

303

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“…In both of those studies, patients who satisfied the criteria were subjected to a 2 hour trial of CPAP while they remained attached to the mechanical ventilator circuit. How exactly a SBT should be performed remains subject to debate, and its optimal duration is not known, although there are data suggesting that it may be shortened [8-11]. For the routine procedure, we arbitrarily chose a 90 min duration and to perform the trial while the patient was disconnected from the ventilator, without adding any positive end-expiratory pressure.…”

Section: Discussionmentioning

confidence: 99%

Untitled

et al. 2005

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Introduction The aim of the study was to determine whether the use of a nurses' protocol-directed weaning procedure, based on the French intensive care society (SRLF) consensus recommendations, was associated with reductions in the duration of mechanical ventilation and intensive care unit (ICU) length of stay in patients requiring more than 48 hours of mechanical ventilation. Methods This prospective study was conducted in a university hospital ICU from January 2002 through to February 2003. A total of 104 patients who had been ventilated for more than 48 hours and were weaned from mechanical ventilation using a nurses' protocol-directed procedure (cases) were compared with a 1:1 matched historical control group who underwent conventional physician-directed weaning (between 1999 and 2001). Duration of ventilation and length of ICU stay, rate of unsuccessful extubation and rate of ventilator-associated pneumonia were compared between cases and controls. Results The duration of mechanical ventilation (16.6 ± 13 days versus 22.5 ± 21 days; P = 0.02) and ICU length of stay (21.6 ± 14.3 days versus 27.6 ± 21.7 days; P = 0.02) were lower among patients who underwent the nurses' protocol-directed weaning than among control individuals. Ventilatorassociated pneumonia, ventilator discontinuation failure rates and ICU mortality were similar between the two groups. Discussion Application of the nurses' protocol-directed weaning procedure described here is safe and promotes significant outcome benefits in patients who require more than 48 hours of mechanical ventilation.

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“…Ely et al [4] showed that immediate extubation after successful trials of spontaneous breathing expedites weaning and reduces the duration of mechanical ventilation as compared with a more gradual discontinuation of ventilatory support. Several studies [1,2,3,4,5,14,15] have demonstrated that 60-80% of mechanically ventilated patients can be successfully extubated after passing a trial of spontaneous breathing.…”

Section: Is the Patient Able To Sustain Spontaneous Breathing?mentioning

confidence: 99%

“…The duration of a spontaneous breathing trial has been set at 2 h in most studies [1,2,4,14,15]. One prospective, multicenter, randomized trial of 526 patients [5] found that trials of spontaneous breathing for 30 or 120 min were equivalent in identifying patients who could tolerate extubation, and that patients had reintubation rates of approximately 13% at 48 h regardless of the duration of their T-tube trial.…”

Section: Is the Patient Able To Sustain Spontaneous Breathing?mentioning

confidence: 99%

Untitled

Alía

Esteban

2000

Crit Care

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Practice guidelines on weaning should be based on the results of several well-designed randomized studies performed over the last decade. One of those studies demonstrated that immediate extubation after successful trials of spontaneous breathing expedites weaning and reduces the duration of mechanical ventilation as compared with a more gradual discontinuation of ventilatory support. Two other studies showed that the ability to breathe spontaneously can be adequately tested by performing a trial with either T-tube or pressure support of 7 cmH 2 O lasting either 30 or 120 min. In patients with unsuccessful weaning trials, a gradual withdrawal for mechanical ventilation can be attempted while factors responsible for the ventilatory dependence are corrected. Two randomized studies found that, in difficult-to-wean patients, synchronized intermittent mandatory ventilation (SIMV) is the most effective method of weaning.

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Clinical Characteristics, Respiratory Functional Parameters, and Outcome of a Two-Hour T-Piece Trial in Patients Weaning from Mechanical Ventilation.

Cited by 84 publications

References 0 publications

BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults

BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults

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