A comparison of two methods to perform a breathing trial before extubation in pediatric intensive care patients.
Intensive Care Med
; 27(10): 1649-54, 2001 Oct.
Article
em En
| MEDLINE
| ID: mdl-11685307
ABSTRACT
OBJECTIVE:
To compare the percentage of infants and children successfully extubated after a trial of breathing performed with either pressure support or T-piece.DESIGN:
Prospective and randomized study.SETTING:
Three medical-surgical pediatric intensive care units (PICUs). PATIENTS Two hundred fifty-seven consecutive infants and children who received mechanical ventilation for at least 48 h and were deemed ready to undergo a breathing trial by their primary physician.INTERVENTIONS:
Patients were randomly assigned to undergo a trial of breathing in one of two ways pressure support of 10 cmH2O or T-piece. Bedside measurements of respiratory function were obtained immediately before discontinuation of mechanical ventilation and within the first 5 min of breathing through a T-piece. The primary physicians were unaware of those measurements, and the decision to extubate a patient at the end of the breathing trial was made by them. MEASUREMENTS AND MAINRESULTS:
Of the 125 patients in the pressure support group, 99 (79.2%) completed the breathing trial and were extubated, but 15 of them (15.1%) required reintubation within 48 h. Of the 132 patients in the T-piece group, 102 (77.5%) completed the breathing trial and were extubated, but 13 of them (12.7%) required reintubation within 48 h. The percentage of patients who remained extubated for 48 h after the breathing trial did not differ in the pressure support and T-piece groups (67.2% versus 67.4%, p=0.97).CONCLUSIONS:
In infants and children mechanically ventilated, successful extubation was achieved equally effectively after a first breathing trial performed with pressure support of 10 cmH2O or a T-piece.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desmame do Respirador
/
Respiração com Pressão Positiva
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Intensive Care Med
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Argentina