The Role of Pressure Support PS in the Weaning from Mechanical Ventilation after Failure a T-tube Trial
Abstract
Study Objective: Evidence that PS may facilitate weaning from mechanical ventilation (MV), although not confirmed by randomized trials, prompted us to investigate whether patients could be weaned with PS after failing a T-tube trial.
Methods: This was a prospective, non-randomized study in surgical intensive care unit in Tishreen Hospital-Lattakia through 2018-2019. Our study included 60 Patients were admitted in surgical intensive care unit and needed mechanical ventilation (MV) > 48 hours. Most of patients meeting the criteria for a weaning test underwent a 30-min T-tube trial. If this was successful, they were immediately extubated. Otherwise, a 30-min trial with PS was immediately initiated. If all weaning criteria were met, the patients were extubated; otherwise, MV was reinstated.
Results: The extubation failure rate at 48 h did not differ significantly between the groups: (11%) versus (10%). The groups were comparable with regard to endotracheal tube diameter, MV duration, the use of non-invasive ventilation (NIV) after extubation, initial severity score, age and underlying pathology, except for COPD. A significantly higher percentage of patients with COPD was extubated after the trial with PS than after a single T-tube trial.
Conclusion: Some of the patients could be extubated after a trial with PS, despite having failed a T-tube trial. The re-intubation rate was not increased after 48 h. This protocol may particularly benefits patients who are more difficult to wean.
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