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 120min. 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 48h and considered ready for a weaning trial. Interventions. An SBT conducted in PSV with 7cmH2O 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 48h; 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 7days, respectively) and in-hospital length of stay (20 and 25days, respectively). Compared to the successfully extubated, the reintubated patients had significantly higher length of ICU stay and mortality (17 vs. 6days and 33 vs. 3.6%, respectively). Conclusions. An SBT with PSV of 7cmH2O lasting 30min is equally effective in recognizing the successfully extubated patients as a 120-min trial.
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Data set: Springer