Weaning Failure Clinical Trial
Official title:
Phase 2 Study of 60-min Rest After Successful Spontaneous Breathing Trial Before Extubation as a Tool for Reduction Post-extubation Failure.
To evaluate if a rest period before extubation after a successful SBT trial could reduce the extubation failure rate.
Intubation and mechanical ventilation are related with several complications. This increased
the risk of mortality of intensive care patients. So, we always look for an early extubation
when patients are recovered for the trigger disease. In spite of standardized manoeuvres to
decided readiness for extubation these are not quite good because it has been described a
failure extubation rate of 5% and a reintubation rate of 15%. Furthermore several risk
factors has been associated with a major failure rate:>65 years old, congestive cardiac
insufficiency, chronic obstructive pulmonary disease, APACHE II >12 the extubation day, BMI
>30, ineffective cough, a lot of bronchial secretions (as the need for >2 endotracheal
suctioning in the last 8h before extubation), failure of a previous SBT,alterations of high
respiratory tract or intubation for more than 7 days.Patients without any of these factors
risk has an extubation failure rate of 10% while if any of these are present extubation
failure increase to 30%.
The most used technique as a weaning trial is named spontaneous breathing trial (SBT). Some
physiological aspects suggest that breathing through an endotracheal tube could be a really
effort trial. So our hypothesis is that a period of rest after SBT and before extubation
could reduce the extubation failure rate.
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