Intensive Care Medicine

, Volume 28, Issue 8, pp 1058–1063

Protocol-directed weaning from mechanical ventilation: clinical outcome in patients randomized for a 30-min or 120-min trial with pressure support ventilation

  • Andreas Perren
  • Guido Domenighetti
  • Simonetta Mauri
  • Franco Genini
  • Nicoletta Vizzardi
Original

DOI: 10.1007/s00134-002-1353-z

Cite this article as:
Perren, A., Domenighetti, G., Mauri, S. et al. Intensive Care Med (2002) 28: 1058. doi:10.1007/s00134-002-1353-z

Abstract

Abstract

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 120 min.

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 48 h and considered ready for a weaning trial.

Interventions. An SBT conducted in PSV with 7 cmH2O 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 48 h; 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 7 days, respectively) and in-hospital length of stay (20 and 25 days, respectively). Compared to the successfully extubated, the reintubated patients had significantly higher length of ICU stay and mortality (17 vs. 6 days and 33 vs. 3.6%, respectively).

Conclusions. An SBT with PSV of 7 cmH2O lasting 30 min is equally effective in recognizing the successfully extubated patients as a 120-min trial.

Weaning Clinical outcome Pressure support ventilation Duration of weaning trial Extubation Adults 

Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Andreas Perren
    • 1
  • Guido Domenighetti
    • 2
  • Simonetta Mauri
    • 2
  • Franco Genini
    • 2
  • Nicoletta Vizzardi
    • 1
  1. 1.Centro Cure Intense, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, SwitzerlandSwitzerland
  2. 2.Cure Intense, Ospedale Regionale La Carità, 6600 Locarno, SwitzerlandSwitzerland