What is it about?

The effort to breathe or work of breathing during a spontaneous breathing trial is best mimicked by a T-piece trial or a trial of non-assisted breathing on the ventilator (zero inspiratory pressure, zero end-expiratory pressure).

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Why is it important?

In terms of physiology, only T-piece trials or unassisted breathing with no pressure well represents the work which the patient will do after extubation and can help the clinician to decide for extubation.

Perspectives

For a patient at risk of extubation failure (high pre test probability of failure)) a realistic test like T-piece or unassisted breathing on the ventilator is very important to avoid risky extubation.

Dr Laurent J Brochard
University of Toronto

Read the Original

This page is a summary of: Effort to Breathe with Various Spontaneous Breathing Trial Techniques. A Physiologic Meta-analysis, American Review of Respiratory Disease, June 2017, American Thoracic Society,
DOI: 10.1164/rccm.201607-1338oc.
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