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Spontaneous awakening trials plus spontaneous breathing trials improved weaning from mechanical ventilation

T D Girard

Dr T D Girard, Vanderbilt University School of Medicine, Nashville, TN, USA; timothy.girard@vanderbilt.edu

QUESTION
In sedated patients on mechanical ventilation, are daily spontaneous awakening trials (SATs) combined with spontaneous breathing trials (SBTs) more effective for ventilator weaning than daily SBTs with sedation per usual care?

METHODS
Design: randomised controlled trial.

Allocation: concealed.

Blinding: unblinded.

Follow-up period: 1 year.

Setting: 4 medical intensive care units (ICUs) in the USA.

Patients: 336 patients 18 years of age (median age 61 y, 52% men) who required mechanical ventilation for 12 hours and were receiving patient-targeted sedation. Exclusion criteria included admission after cardiac arrest, continuous ventilation for 2 weeks, and profound neurological deficits.

Intervention: daily SAT followed by SBT (n = 168) or daily SBT with sedation per usual care (n = 168). In the SAT + SBT group, patients who passed an SAT safety screen had an SAT. Patients who failed the . . . [Full text of this article]

Kelley Kilpatrick

McGill University School of Nursing, Montreal, Quebec, Canada