Intensive Care Medicine

, Volume 27, Issue 10, pp 1649–1654

A comparison of two methods to perform a breathing trial before extubation in pediatric intensive care patients

  • J. Farias
  • A. Retta
  • I. Alía
  • F. Olazarri
  • A. Esteban
  • A. Golubicki
  • D. Allende
  • O. Maliarchuk
  • C. Peltzer
  • M. Ratto
  • R. Zalazar
  • M. Garea
  • E. Moreno
Neonatal and Pediatric Intensive Care

DOI: 10.1007/s001340101035

Cite this article as:
Farias, J., Retta, A., Alía, I. et al. Intensive Care Med (2001) 27: 1649. doi:10.1007/s001340101035

Abstract.

Objective: To compare the percentage of infants and children successfully extubated after a trial of breathing performed with either pressure support or T-piece. Design: Prospective and randomized study. Setting: Three medical-surgical pediatric intensive care units (PICUs). Patients: Two hundred fifty-seven consecutive infants and children who received mechanical ventilation for at least 48 h and were deemed ready to undergo a breathing trial by their primary physician. Interventions: Patients were randomly assigned to undergo a trial of breathing in one of two ways: pressure support of 10 cmH2O or T-piece. Bedside measurements of respiratory function were obtained immediately before discontinuation of mechanical ventilation and within the first 5 min of breathing through a T-piece. The primary physicians were unaware of those measurements, and the decision to extubate a patient at the end of the breathing trial was made by them. Measurements and main results: Of the 125 patients in the pressure support group, 99 (79.2%) completed the breathing trial and were extubated, but 15 of them (15.1%) required reintubation within 48 h. Of the 132 patients in the T-piece group, 102 (77.5%) completed the breathing trial and were extubated, but 13 of them (12.7%) required reintubation within 48 h. The percentage of patients who remained extubated for 48 h after the breathing trial did not differ in the pressure support and T-piece groups (67.2% versus 67.4%, p=0.97). Conclusions: In infants and children mechanically ventilated, successful extubation was achieved equally effectively after a first breathing trial performed with pressure support of 10 cmH2O or a T-piece.

Weaning Mechanical ventilation Children Weaning indices Pressure support ventilation T-piece 

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • J. Farias
    • 1
  • A. Retta
    • 1
  • I. Alía
    • 2
  • F. Olazarri
    • 1
  • A. Esteban
    • 2
  • A. Golubicki
    • 1
  • D. Allende
    • 3
  • O. Maliarchuk
    • 3
  • C. Peltzer
    • 4
  • M. Ratto
    • 4
  • R. Zalazar
    • 1
  • M. Garea
    • 1
  • E. Moreno
    • 1
  1. 1.Unidad de Cuidados Intensivos Pediátricos, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, 1425 Buenos Aires, ArgentinaArgentina
  2. 2.Unidad de Cuidados Intensivos, Hospital Universitario de Getafe, Madrid, SpainSpain
  3. 3.Unidad de Cuidados Intensivos Pediátricos, Hospital Interzonal, Neuquén, ArgentinaArgentina
  4. 4.Unidad de Cuidados Intensivos Pediátricos, Hospital de Niños Sor María Ludovica, La Plata, Buenos Aires, ArgentinaArgentina