scholarly journals Automatic Tube Compensation versus Pressure Support Ventilation and Extubation Outcome in Children: A Randomized Controlled Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ahmed Saad El-din El-beleidy ◽  
Asser Abd EL-Hamied Khattab ◽  
Seham Awad El-Sherbini ◽  
Hebatalla Fadel Al-gebaly
Keyword(s):  
Risk Factors ◽  
Pressure Support Ventilation ◽  
Predictive Value ◽  
Spontaneous Breathing ◽  
Pressure Support ◽  
Spontaneous Breathing Trial ◽  
Extubation Failure ◽  
Support Ventilation ◽  
Extubation Outcome ◽  
Tube Compensation

Background. Automatic tube compensation (ATC) has been developed to overcome the imposed work of breathing due to artificial airways during spontaneous breathing trials (SBTs). Objectives. This study aimed to assess extubation outcome after an SBT (spontaneous breathing trial) with ATC compared with pressure support ventilation (PSV) and to determine the risk factors for extubation failure. Methods. Patients ready for extubation were randomly assigned to two-hour spontaneous breathing trial with either ATC or pressure support ventilation. Results. In the ATC group (), 11 (65%) patients passed the SBT with subsequent extubation failure (9%). While in PSV group (), 10 (53%) patients passed the SBT with subsequent extubation failure (10%). This represented a positive predictive value for ATC of 91% and PSV of 90% (). Five (83%) of the patients who failed the SBT in ATC group were reintubated. This represented a higher negative predictive value for ATC of 83% than for PSV which was 56%. None of the assessed risk factors were independently associated with extubation failure including failed trial. Conclusion. ATC was equivalent to PSV in predicting patients with successful extubation. A trial failure in ATC group is associated with but does not definitely predict extubation failure.

Accuracy of a spontaneous breathing trial for extubation of neonates

2020 ◽  
pp. 1-8
Author(s):  
M. Fiatt ◽  
A.C. Bosio ◽  
D. Neves ◽  
R. Symanski da Cunha ◽  
L.T. Fonseca ◽  
...  
Keyword(s):  
Predictive Value ◽  
Spontaneous Breathing ◽  
Pressure Support ◽  
Spontaneous Breathing Trial ◽  
Invasive Mechanical Ventilation ◽  
Newborn Infants ◽  
Extubation Failure ◽  
Great Accuracy ◽  
Minimum Pressure ◽  
Persistent Arterial Duct

BACKGROUND: Prevalence of extubation failure in neonates may be up to 80%, but evidence to determine if a neonate is ready for extubation remains unclear. We aim to evaluate a spontaneous breathing trial accuracy with minimum pressure support to predict success in neonates’ extubation and identify variables related to failures. METHODS: This is a diagnostic accuracy study based on a cohort study in an intensive care unit with all eligible newborn infants subjected to invasive mechanical ventilation for at least 24 hours submitted to the trial for 10 minutes before extubations. The outcome was failures of extubations, considered if reintubation was needed until 72 hours. RESULTS: The incidence of failure was 14.7%among 170 extubations. There were 145 successful extubations; of these, 140 also passed the trial with a sensitivity of 96.5%(95%CI: 92.1–98.9). Of the 25 extubations that eventually failed, 16 failed the test with a specificity of 64.0%(95%CI: 42.5–82.0). The negative predictive value was 76.2%, and the positive predictive value was 94%. In stratifying by weight, the accuracy was >98.7%for neonates weighting >2500 g, but 72.5%for those weighing <1250 g. Extubation failures occurred more frequently in smaller (p = 0.01), preterm infants (p = 0.17), with longer ventilation time (p = 0.05), and having a hemodynamically significant persistent arterial duct (p = 0.01), compared with infants whose extubation was successful. CONCLUSION: The spontaneous breathing trial with minimum pressure support ventilation seems to predict extubation success with great accuracy in full-term and larger neonates.

Extubation Outcome after Spontaneous Breathing Trials with T-Tube or Pressure Support Ventilation

1997 ◽  
Vol 156 (2) ◽  
pp. 459-465 ◽  
Author(s):  
ANDRÉS ESTEBAN ◽  
INMACULADA ALÍA ◽  
FEDERICO GORDO ◽  
RAFAEL FERNÁNDEZ ◽  
JOSÉ F. SOLSONA ◽  
...  
Keyword(s):  
Pressure Support Ventilation ◽  
Spontaneous Breathing ◽  
Pressure Support ◽  
Support Ventilation ◽  
T Tube ◽  
Extubation Outcome ◽  
Spontaneous Breathing Trials
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