Association Between Spontaneous Breathing Trial Methods and Reintubation in Adult Critically Ill Patients

Ippolito, Mariachiara; Sardo, Salvatore; Tripodi, Vincenzo Francesco; Latronico, Nicola; Bignami, Elena; Giarratano, Antonino; Cortegiani, Andrea

doi:10.1016/j.chest.2024.06.3773

CHEST

2024

DOI: 10.1016/j.chest.2024.06.3773

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Association Between Spontaneous Breathing Trial Methods and Reintubation in Adult Critically Ill Patients

Mariachiara Ippolito,

Salvatore Sardo,

Vincenzo Francesco Tripodi

et al.

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2024

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Cited by 3 publications

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Incidence of unplanned extubation in French intensive care units: are we ready for a SAFE-ICU plan!

Vetrugno,

Cortegiani

2024

Anaesthesia Critical Care & Pain Medicine

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Incidence of unplanned extubation in French intensive care units: are we ready for a SAFE-ICU plan!

Vetrugno,

Cortegiani

2024

Anaesthesia Critical Care & Pain Medicine

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Identifying the Best Method for Performing a Spontaneous Breathing Trial

Cardinal-Fernández,

Collazo,

Villanueva

2024

CHEST

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Spontaneous breathing trials: how and for how long?

Thille,

Arrivé,

Le Pape

2024

Current Opinion in Critical Care

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Purpose of review Guidelines recommend systematic performance of a spontaneous breathing trial (SBT) before extubation in ICUs, the objective being to reduce the risk of reintubation. In theory, a more challenging SBT performed with a T-piece may further reduce the risk of reintubation, whereas a less challenging SBT performed with pressure-support ventilation (PSV) may hasten extubation. Recent findings Recent findings show that a more challenging SBT with a T-piece or for a prolonged duration do not help to reduce the risk of reintubation. In contrast, a less challenging SBT with PSV is easier to pass than a T-piece, and may hasten extubation without increased risk of reintubation. Although SBT with PSV and additional positive end-expiratory pressure is indeed a less challenging SBT, further studies are needed to generalize such an easy trial in daily practice. Earlier screening for a first SBT may also decrease time to extubation without increased risk of reintubation. Lastly, reconnection to the ventilator for a short period after successful SBT facilitates recovery from the SBT-induced alveolar derecruitment. Summary Several recent clinical trials have improved assessment of the most adequate way to perform SBT before extubation.

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Association Between Spontaneous Breathing Trial Methods and Reintubation in Adult Critically Ill Patients

Cited by 3 publications

References 41 publications

Incidence of unplanned extubation in French intensive care units: are we ready for a SAFE-ICU plan!

Incidence of unplanned extubation in French intensive care units: are we ready for a SAFE-ICU plan!

Identifying the Best Method for Performing a Spontaneous Breathing Trial

Spontaneous breathing trials: how and for how long?

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