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Pressure-support ventilation or T-piece spontaneous breathing trials for patients with chronic obstructive pulmonary disease - A randomized controlled trial

Author

Listed:
  • José Augusto Santos Pellegrini
  • Márcio Manozzo Boniatti
  • Viviane Corrêa Boniatti
  • Crislene Zigiotto
  • Marina Verçoza Viana
  • Wagner Luiz Nedel
  • Leonardo da Silva Marques
  • Moreno Calcagnotto dos Santos
  • Clarissa Balbão de Almeida
  • Cláudia Pellizzer Dal’ Pizzol
  • Patrícia Klarmann Ziegelmann
  • Sílvia Regina Rios Vieira

Abstract

Background: Little is known about the best strategy for weaning patients with chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Spontaneous breathing trials (SBT) using a T-piece or pressure-support ventilation (PSV) have a central role in this process. Our aim was to compare T-piece and PSV SBTs according to the duration of mechanical ventilation (MV) in patients with COPD. Methods: Patients with COPD who had at least 48 hours of invasive MV support were randomized to 30 minutes of T-piece or PSV at 10 cm H2O after being considered able to undergo a SBT. All patients were preemptively connected to non-invasive ventilation after extubation. Tracheostomized patients were excluded. The primary outcome was total invasive MV duration. Time to liberation from MV was assessed as secondary outcome. Results: Between 2012 and 2016, 190 patients were randomized to T-piece (99) or PSV (91) groups. Extubation at first SBT was achieved in 78% of patients. The mean total MV duration was 10.82 ± 9.1 days for the T-piece group and 7.31 ± 4.9 days for the PSV group (p

Suggested Citation

  • José Augusto Santos Pellegrini & Márcio Manozzo Boniatti & Viviane Corrêa Boniatti & Crislene Zigiotto & Marina Verçoza Viana & Wagner Luiz Nedel & Leonardo da Silva Marques & Moreno Calcagnotto dos S, 2018. "Pressure-support ventilation or T-piece spontaneous breathing trials for patients with chronic obstructive pulmonary disease - A randomized controlled trial," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-14, August.
    • Handle: RePEc:plo:pone00:0202404
    DOI: 10.1371/journal.pone.0202404
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