scholarly journals Prediction of extubation outcome: a randomised, controlled trial with automatic tube compensation vs. pressure support ventilation

Critical Care ◽  
2009 ◽  
Vol 13 (1) ◽  
pp. R21 ◽  
Author(s):  
Jonathan Cohen ◽  
Maury Shapiro ◽  
Elad Grozovski ◽  
Ben Fox ◽  
Shaul Lev ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Controlled Trial ◽  
Support Ventilation ◽  
Extubation Outcome ◽  
Randomised Controlled ◽  
Tube Compensation

scholarly journals T-piece versus pressure-support ventilation for spontaneous breathing trials before extubation in patients at high risk of reintubation: protocol for a multicentre, randomised controlled trial (TIP-EX)

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042619
Author(s):  
Arnaud W Thille ◽  
Rémi Coudroy ◽  
Arnaud Gacouin ◽  
Stephan Ehrmann ◽  
Damien Contou ◽  
...  
Keyword(s):  
High Risk ◽  
Randomised Controlled Trial ◽  
Pressure Support Ventilation ◽  
Spontaneous Breathing ◽  
Pressure Support ◽  
Controlled Trial ◽  
Invasive Mechanical Ventilation ◽  
Support Ventilation ◽  
Number Of Patients ◽  
Randomised Controlled

IntroductionIn intensive care unit (ICU), the decision of extubation is a critical time because mortality is particularly high in case of reintubation. To reduce that risk, guidelines recommend to systematically perform a spontaneous breathing trial (SBT) before extubation in order to mimic the postextubation physiological conditions. SBT is usually performed with a T-piece disconnecting the patient from the ventilator or with low levels of pressure-support ventilation (PSV). However, work of breathing is lower during PSV than during T-piece. Consequently, while PSV trial may hasten extubation, it may also increase the risk of reintubation. We hypothesise that, compared with T-piece, SBT performed using PSV may hasten extubation without increasing the risk of reintubation.Methods and analysisThis study is an investigator-initiated, multicentre randomised controlled trial comparing T-piece vs PSV for SBTs in patients at high risk of reintubation in ICUs. Nine hundred patients will be randomised with a 1:1 ratio in two groups according to the type of SBT. The primary outcome is the number of ventilator-free days at day 28, defined as the number of days alive and without invasive mechanical ventilation between the initial SBT (day 1) and day 28. Secondary outcomes include the number of days between the initial SBT and the first extubation attempt, weaning difficulty, the number of patients extubated after the initial SBT and not reintubated within the following 72 hours, the number of patients extubated within the 7 days following the initial SBT, the number of patients reintubated within the 7 days following extubation, in-ICU length of stay and mortality in ICU, at day 28 and at day 90.Ethics and disseminationThe study has been approved by the central ethics committee ‘Ile de France V’ (2019-A02151-56) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT04227639.

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.

Automatic Tube Compensation Versus Pressure Support Ventilation as a Weaning Mode, Does It Make a Difference?

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 312A
Author(s):  
Safaa Wafy ◽  
Hamad El-Shahat ◽  
Suzan Salama ◽  
Hassan Bayoumi
Keyword(s):  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Support Ventilation ◽  
Tube Compensation
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