SBT and SAT spontaneous awakening and breathing trials
- related: ICU intensive care unit
- tags: #literature
- source: AHRQ
- initiate SBT when ventilator is at lowest setting
- ABC trial showed SBT with SAT is beneficial
- DahLIA trial found precedex helps earlier extubation in agitated patients
- spice III found higher mortality in younger patients with precedex
- 30 min SBT is better than 2 hours SBT
SAT
Contraindications
- needing more sedation for agitation, seizure, withdrawal
- paralyzed
- increased intracranial pressure
- active MI in last 24 hours
Failing SAT
- signs of respiratory distress
- signs of agitation, pain, anxiety
- hypoxia
- arrythmia
SBT
Contraindications
- needing high vent settings, PEEP > 8, FiO2 > 50%
- No spontaneous respiratory effort in 5 min period
- increased intracranial pressure
- very high pressor requirements
Failing SBT
- sedation is restarted at half prior dose if patient fails either SAT or SBT