Spontaneous Breathing Trials and Successful Extubation
To the Editor The results of the randomized clinical trial reported by Dr Subir à and colleagues compared a less demanding spontaneous breathing trial (SBT) of 30 minutes of pressure support ventilation (PSV) with a more demanding 2-hour T-piece SBT and showed a higher successful extubation rate favoring the less demanding test without a higher need for reintubation. In this t rial, clinicians, who were not blinded to treatment assignment, made greater use of prophylactic respiratory interventions in the PSV group (24.7%) (8.9% noninvasive ventilation [NIV] + 15.8% high-flow nasal cannula [HFNC]) compared with the T-piece group (18.7%) (5.9% NIV + 12.8% HFNC). This analys is is limited to prophylactic use and not total use of NIV and HFNC after extubation. Moreover, it assumes that individual patients were treated prophylactically with either NIV or HFNC but not both.
Source: JAMA - Category: General Medicine Source Type: research