Characteristics of Subjects Who Failed a 120-Minute Spontaneous Breathing Trial.

BACKGROUND: The objective of this work was to identify the unique characteristics of patients who experienced success in a 30-min spontaneous breathing trial (SBT) but failed at 120 min. METHODS: Patients who had received mechanical ventilation for >24 h were eligible for inclusion in this study. Th...

Descripción completa

Detalles Bibliográficos
Publicado en:Respiratory Care Vol. 63; no. 4; pp. 388 - 395
Autores principales: Guopeng Liang, Tingting Liu, Yihua Zeng
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Apr2018
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128622754&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 128622754
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00201324
        4GG
      jtl: Respiratory Care
      issn: 00201324
      maglogo: N
    pubinfo:
      dt: Apr2018
      vid: 63
      iid: 4
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
    artinfo:
      ui:
        128622754
        128622754
        128622754
        10.4187/respcare.05820
        128622754
      ppf: 388
      ppct: 7
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Characteristics of Subjects Who Failed a 120-Minute Spontaneous Breathing Trial.
      aug:
        au:
          Guopeng Liang
          Tingting Liu
          Yihua Zeng
        affil: Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
      sug:
        subj:
          Respiration Evaluation
          Patient Assessment
          Respiration, Artificial
          Human
          Data Analysis Software
          Patient Selection
          Control Group
          Risk Factors
          Heart Diseases Diagnosis
          Lung Diseases Diagnosis
          Aged
          Aged, 80 and Over
          Male
          Female
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: BACKGROUND: The objective of this work was to identify the unique characteristics of patients who experienced success in a 30-min spontaneous breathing trial (SBT) but failed at 120 min. METHODS: Patients who had received mechanical ventilation for >24 h were eligible for inclusion in this study. The SBT was performed by 7 cm H2O of pressure support with zero PEEP. After a successful 120-min SBT, weaning from mechanical ventilation was performed. Data were collected at 30 and 120 min or at the failure of the SBT. All patients who successfully completed a 30-min SBT were enrolled. RESULTS: We enrolled 352 subjects in this study. Of these, 311 subjects (88.4%) directly completed a 120-min SBT (success group), and 41 subjects (11.6%) passed the test for at least 30 min but failed before 120 min (failure group). In data collected before the SBT, presence of chronic cardiopulmonary disease, number of previous SBT attempts before 30-min SBT success, age, and PaCO2 were independently associated with 120-min SBT failure. A scale was developed that used these 4 variables. The failure rate was low in subjects with ≤2 points (3%) but significantly higher in subjects with >2 points (46%). In data collected at the 30-min SBT, PaCO2, rapid shallow breathing index, ΔPaO2/FIO2, Δbreathing frequency, and ΔpH were independently associated with 120-min SBT failure. These 5 variables were then used to develop another scale to predict SBT success. Similar to the previous score, the failure rate was low in subjects with ≤2 points (1%) and significantly higher in subjects with >2 points (55%). CONCLUSIONS: This study highlights differences between subjects who completed a 120-min SBT and those who succeeded at 30 min but failed by 120 min. In subjects with a score >2 points, reflecting a greater risk of SBT failure, a 120-min SBT may be required.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N