Extubation

Q: Is the following statement  true:

"If patients were rested back on the ventilator for an hour before extubation after the completion of a spontaneous breathing trial (SBT), it may decrease the rate of reintubation at 48 hours".

A) Yes
B) No


Answer: Yes

One relative recent trial of 18 institutions from Spain comprising of 243 patients randomized to the control group and 227 to the rest group, showed that the above strategy decreased the reintubation at 48 hours from 14% to 5%. The multivariable regression model demonstrated that the variables independently associated were rest, APACHE II, and days of ventilation before SBT. Interestingly, age, reason for admission, and the type and duration of SBT were not associated with decrease in reintubation rate. 

Although, the study was well conducted but still requires reproducibility of results.

#Ventilation
#pulmonary


Reference:

1. Fernandez MM, González-Castro A, Magret M, et al. Reconnection to mechanical ventilation for 1 h after a successful spontaneous breathing trial reduces reintubation in critically ill patients: a multicenter randomized controlled trial. Intensive Care Med 2017; 43:1660.