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Effect of Spontaneous Breathing Trial Duration ... - ATS Journals

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The duration of spontaneous breathing trials in research studies has been set at 2 h (5, 7-9), but patients who fail a trial tend to declare ... AmericanJournalofRespiratoryandCriticalCareMedicine Home > AmericanJournalofRespiratoryandCriticalCareMedicine > ListofIssues > Volume159,Issue2 > EffectofSpontaneousBreathingTrialDurationonOutcomeofAttemptstoDiscontinueMechanicalVentilation Abstract SendtoCitationMgr AddtoFavorites EmailtoaFriend TrackCitations EffectofSpontaneousBreathingTrialDurationonOutcomeofAttemptstoDiscontinueMechanicalVentilation ANDRÉSESTEBANxSearchforarticlesbythisauthor,INMACULADAALÍAxSearchforarticlesbythisauthor,MARTIN J.TOBINxSearchforarticlesbythisauthor,ANSELMOGILxSearchforarticlesbythisauthor,FEDERICOGORDOxSearchforarticlesbythisauthor,INMACULADAVALLVERDÚxSearchforarticlesbythisauthor,LLUISBLANCHxSearchforarticlesbythisauthor,ALFONSOBONETxSearchforarticlesbythisauthor,ANTONIAVÁZQUEZxSearchforarticlesbythisauthor,RAULdePABLOxSearchforarticlesbythisauthor,ANTONIOTORRESxSearchforarticlesbythisauthor,MIGUEL A.delaCALxSearchforarticlesbythisauthor,andSANTIAGOMACÍAS*xSearchforarticlesbythisauthorfor the Spanish Lung Failure Collaborative GroupShowAll... https://doi.org/10.1164/ajrccm.159.2.9803106       PubMed:9927366 Received:March24,1998 Abstract FullText References Citedby PDF AbstractSection:ChooseTopofpageAbstract<50mmHg);(4)clinicalsignsofincreasedrespiratorywork(atleastoneofthefollowing:recessionofthesuprasternalnotch,retractionoftheintercostalspaces,accessorymusclerecruitment,paradoxicalmotionoftheabdomen);(5)impairedclearanceofsecretions;(6)cardiacfailure;( 7 )atelectasis;and(8)decreasedconsciousness;andifanothercausewasresponsible,thiswaslisted.Complicationsthatoccurredduringorafterreintubationwerenotedatthattime.PneumoniawasdefinedasanewandpersistentinfiltrationonachestX-ray,feverorhypothermia,purulentsputum,andachangeinFiO2requirements.StatisticalAnalysisWehavepreviouslyreportedthat62%ofventilatedpatientscanbesuccessfullyextubatedaftera2-htrialofspontaneousbreathing(8).Wecalculatedthat220patientswereneededineachgrouptodetecta20%differenceinthepercentageofsuccessfullyextubatedpatients(fromtheexpected62%to75%)atapowerof80%withatwo-tailed,typeIerrorof0.05.Dataarepresentedasmedianswith25thand75thcentilerange,oraspercentages,asappropriate.Allcategoricalvariableswereanalyzedwithchi-squaretests,exceptwheresmallsizerequiredtheuseofFisher'sexacttest.ComparisonofcontinuousvariablesamongthetwogroupswasdonewithStudent'sttestforvariableswithnormaldistribution,andwiththeMann–WhitneyUtestforvariableswithnonnormaldistribution.Comparisonsamongthefollowingthreegroups:(1)patientswhofailedthespontaneousbreathingtrial(trialfailuregroup);(2)patientssuccessfullyextubated(successfulextubationgroup);and(3)patientsreintubatedwithin48h(reintubationgroup)weremadethroughone-wayanalysisofvariance(ANOVA)forcontinuousvariableswithnormaldistribution,andthroughtheKruskall–Wallistestforvariableswithnonnormaldistribution.Theincrementalareaunderthecurvewasusedasasummarystatistic(13)forcomparingeachpatient'smeasurementsforrespiratoryfrequency,HR,systolicbloodpressure,andSaO2duringthetrialofspontaneousbreathingamongthetrialfailuregroup,thesuccessfulextubationgroup,andthereintubationgroup.RESULTSSection:ChooseTopofpageAbstractMETHODSRESULTS<

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