30 min pressure support SBT is better than 2 hours T piece

• related: SBT and SAT spontaneous awakening and breathing trials
• tags: #permanent

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A small randomized controlled trial decades ago demonstrated that weaning using pressure support ventilation resulted in more successful extubations (defined as being liberated from mechanical ventilation for at least 48 h) and fewer weaning failures (defined as still receiving mechanical ventilation after 21 days) than did either T-piece weaning trials or weaning using synchronized intermittent mandatory ventilation (23% vs 43% vs 42% weaning failures, respectively) (choice A is incorrect).¹

A more recent, larger randomized controlled trial published in JAMA confirmed that using 30-min pressure support spontaneous breathing trials resulted in more successful extubations for at least 72 h and fewer reintubations than did using T-piece trials for 2 h for spontaneous breathing trials (choice C is incorrect).²

Links to this note

• SBT and SAT spontaneous awakening and breathing trials
  • 30 min pressure support SBT is better than 2 hours T piece

Footnotes

1. Subirà C, Hernández G, Vázquez A, et al. Effect of pressure support vs T-piece ventilation strategies during spontaneous breathing trials on successful extubation among patients receiving mechanical ventilation: a randomized clinical trial. JAMA. 2019;321(22):2175-2182. PubMed ↩

2. Ely EW, Baker AM, Dunagan DP, et al. Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med. 1996;335(25):1864-1869. PubMed ↩