Effect Of Spontaneous Breathing Trial Duration On Outcome Of Attempts To Discontinue Mechanical Ventilation

Abstract

Although•. complications•increa:se•witlrprolonged•duration:of.mechanica!•ventilationStill premature• weaning•.leads:to cardiopulmonary: deterioration:• We•designed•this•study to compare•the:.clinical•outcome of trials of spontaneous breathing.witlr a-T-tube circuit with tar-get durations • of 30 and •120 min: We•also•assessed the accuracy of both•the-APACHE ILscore;. which:.is:•an •index• of illness severity;. as• well• as the• indices.that guide•the weaning • process in predicting the•outcome•of weaning: Thirty clinically•ill•patients were randomly• assigned . to two•groups•after fulfilling inclusion•criteria:APACHE H score as well• as•. the other• indices.. that guide: in•• weaningwere•registered for later•evaluaticirrof their •.accuracy:•. Group• L (15 patients)-underwent a 30 min•trial•of spontaneous breathing with::a T-tube:circuit. Group II (15 patients) underwent a 120•min•trial: Respiratory frequency,:.. heart .rate, systolic- blood••pressure:•and• oxygen•.saturation••(Sa02) were recorded every •-]5• min. The• results• of our study showed thatthere•was.no difference between• groups• I. and:• H in achieving:• successful extubation•(73.3% and 66 7% respectively;. P=l.O); rates• of reintubation•(:l3.3% and 26:7% respectively,.P=0.648); or in• mortality••rate:(-100%). Accordingly;. a: 30••min trial••of spontaneous breath-ing is effective: regardless of the. indication.: for mechanical• ventilation: This• Study also con.firmed•.that.mortality• rate• is markedly• higher in• patients•whorequire reintubation within•-48: hours:after.extubation•than•in patients•who•tolerate•extubation: Our study•also showed that: both;...the.• indices• of•weaning; as.• well• as•theAPACHE- II score are•good detennioants• of:weaning.success: We-recommend that patients with•APACHE ll•sccire ± 10 should.•.be• revised before••weaning and•atrial-to correct causes•ofrespiratory•failure should be done:"It is safer to•avoidextubation•untilAPACHE•JI•score-<10