Improved Extubation Rates and Earlier Liberation from Mechanical Ventilation with Implementation of a Daily Spontaneous-Breathing Trial Protocol
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摘要
This was a prospective, observational study which included 355 mechanically ventilated patients. Daily assessments were made of whether the patients met criteria for performing a SBT. On the day a patient met the criteria, the level of sedation was evaluated using the Glasgow Coma Scale as modified by Cook and Palma (GCS-Cook) and it was registered whether or not the physician carried out an SBT.

Results

Two hundred and four patients (57%) underwent an SBT on the day they met the criteria (cohort 1) and in 151 patients (cohort 2) the SBT was delayed a median time of 1 day (interquartile range 1–2). There were differences in the GCS-Cook score on the day the criteria were met for performing an SBT (mean 13 ± 3 points in cohort 1 versus 9 ± 3 points in cohort 2; P < 0.001). There were differences (P < 0.001) between the cohorts in days of intubation and length of stay in the intensive care unit.

Conclusions

Neurological status/level of sedation is a factor in the decision whether or not to perform a spontaneous breathing trial.


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Copyright © 2008 American College of Surgeons Published by Elsevier Inc.

Original scientific article

Improved Extubation Rates and Earlier Liberation from Mechanical Ventilation with Implementation of a Daily Spontaneous-Breathing Trial Protocol

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