Reconnection to mechanical ventilation for 1 h after a successful spontaneous breathing trial reduces reintubation in critically ill patients: a multicenter randomized controlled trial
| Autor: | M.M. Fernández, M. Teresa Bouza, Begoña Balerdi, José Ferreres, Marta Alabert, Susana Altaba, Marcos Ibañez, R. Tomás, Monica Magret, Ana Isabel Tizón, Rafael Fernandez, A. Mas, Noemi Llamas, Alejandro González-Castro, Francisco Andrés Triguero Ruiz, José M. Añón, C García, Vanesa Arauzo |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Critical Illness medicine.medical_treatment Airway Extubation Critical Care and Intensive Care Medicine Severity of Illness Index Spontaneous breathing trial law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Intensive care Multicenter trial Intubation Intratracheal medicine Humans Prospective Studies 030212 general & internal medicine APACHE Aged Mechanical ventilation Intention-to-treat analysis APACHE II business.industry Middle Aged Respiration Artificial Intention to Treat Analysis Surgery Intensive Care Units 030228 respiratory system Multivariate Analysis Female Respiratory Insufficiency business Ventilator Weaning |
| Zdroj: | Intensive Care Medicine. 43:1660-1667 |
| ISSN: | 1432-1238 0342-4642 |
| Popis: | Spontaneous breathing trials (SBT) can be exhausting, but the preventive role of rest has never been studied. This study aimed to evaluate whether reconnection to mechanical ventilation (MV) for 1 h after the effort of a successful SBT could reduce the need for reintubation in critically ill patients. Randomized multicenter trial conducted in 17 Spanish medical-surgical intensive care units (Oct 2013–Jan 2015). Patients under MV for longer than 12 h who fulfilled criteria for planned extubation were randomly allocated after a successful SBT to direct extubation (control group) or reconnection to the ventilator for a 1-h rest before extubation (rest group). The primary outcome was reintubation within 48 h. Analysis was by intention to treat. We recruited 243 patients randomized to the control group and 227 to the rest group. Median time from intubation to SBT did not differ between groups [5.5 (2.7, 9.6) days in the control group vs. 5.7 (2.7, 10.6) in the rest group; p = 0.85]. Reintubation within 48 h after extubation was more common in the control than in the rest group [35 (14%) vs. 12 (5%) patients; OR 0.33; 95% CI 0.16–0.65; p |
| Databáze: | OpenAIRE |
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