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Pressure-support ventilation or T-piece spontaneous breathing trials for patients with chronic obstructive pulmonary disease : a randomized controlled trial
- Source :
- Repositório Institucional da UFRGS, Universidade Federal do Rio Grande do Sul (UFRGS), instacron:UFRGS, PLoS ONE, Repositório Institucional do Centro Universitário La Salle, Universidade La Salle (UNILASALLE), instacron:UNILASALLE, PLoS ONE, Vol 13, Iss 8, p e0202404 (2018)
- Publication Year :
- 2018
-
Abstract
- Submitted by DSpace Unilasalle (dspace@unilasalle.edu.br) on 2021-09-13T15:23:44Z No. of bitstreams: 1 jaspellegrini.etal.pdf: 681346 bytes, checksum: 1db6b5f721b51a74a31b4e3315673762 (MD5) Made available in DSpace on 2021-09-13T15:23:44Z (GMT). No. of bitstreams: 1 jaspellegrini.etal.pdf: 681346 bytes, checksum: 1db6b5f721b51a74a31b4e3315673762 (MD5) Previous issue date: 2018 ackground 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 < 0.001); however, the pre-SBT duration also differed (7.35 ± 3.9 and 5.84 ± 3.3, respectively; p = 0.002). The time to liberation was 8.36 ± 11.04 days for the T-piece group and 4.06 ± 4.94 for the PSV group (univariate mean ratio = 2.06 [1.29–3.27], p = 0.003) for the subgroup of patients with difficult or prolonged weaning. The study group was independently associated with the time to liberation in this subgroup. Conclusions The SBT technique did not influence MV duration for patients with COPD. For the difficult/prolonged weaning subgroup, the T-piece may be associated with a longer time to liberation, although this should be clarified by further studies.
- Subjects :
- Male
Pressure-support ventilation
Pulmonology
Physiology
medicine.medical_treatment
lcsh:Medicine
Blood Pressure
Vascular Medicine
law.invention
Positive-Pressure Respiration
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
Mathematical and Statistical Techniques
Randomized controlled trial
law
Heart Rate
Doença pulmonar obstrutiva crônica
Medicine and Health Sciences
Medicine
030212 general & internal medicine
lcsh:Science
COPD
Multidisciplinary
Respiration
Middle Aged
Ventiladores mecânicos
Intensive care unit
Hospitals
Intensive Care Units
Chemistry
Respiração artificial
Breathing
Anesthesia
Physical Sciences
Female
Ventilator Weaning
Respiração com pressão positiva
Statistics (Mathematics)
Research Article
Chemical Elements
Death Rates
Chronic Obstructive Pulmonary Disease
Intensive Care Unit
Cardiology
Pressure support ventilation
Research and Analysis Methods
Ensaio clínico controlado aleatório
03 medical and health sciences
Population Metrics
Weaning
Humans
Statistical Methods
Aged
Mechanical ventilation
Population Biology
business.industry
lcsh:R
Biology and Life Sciences
medicine.disease
Health Care
Oxygen
Blood pressure
030228 respiratory system
Health Care Facilities
lcsh:Q
business
Physiological Processes
Mathematics
Generalized Linear Model
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Repositório Institucional da UFRGS, Universidade Federal do Rio Grande do Sul (UFRGS), instacron:UFRGS, PLoS ONE, Repositório Institucional do Centro Universitário La Salle, Universidade La Salle (UNILASALLE), instacron:UNILASALLE, PLoS ONE, Vol 13, Iss 8, p e0202404 (2018)
- Accession number :
- edsair.doi.dedup.....03fa255ad57e1bb21bad9dd70b628b46