COMPARISON OF PRESSURE SUPPORT VENTILATION AND T-TUBE AS SPONTANEOUS BREATHING TRIAL TO WEAN FROM MECHANICAL VENTILATION

Abstract

Objective: The objective of this study was to determine weaning success between T-tube and Pressure Support ventilation (PSV) as Spontaneous Breathing trials in terms of total duration of Mechanical Ventilation, time of weaning from Mechanical Ventilation, length of Intensive Care Unit (ICU) stay, rate of successful extubation, failure of extubation and ICU mortality.

Materials and methods: We carried out a prospective, randomized, observational study involving 42 patients who received mechanical ventilation for any duration in ICU. The patients were randomly assigned to a 2-h trial spontaneous breathing trial either with a T-tube (n = 21) or PSV of 8 cm H2O (n = 21), after fulfilling the clinical criteria for weaning. The patient who failed the initial spontaneous breathing trial was excluded from the study. The patients who successfully fulfilled weaning criteria were extubated. According to the patient characteristics, objective parameters, and procedure outcomes, the two methods of weaning were compared. The outcome measures included were total time of Mechanical Ventilation (MV), total time of weaning
from MV, total length of ICU stay, rate of successful extubation, rate of reintubation required, and ICU mortality.

Results: All 42 patients in both T-tube (n=21) and PSV (n=21) group completed 2-h trial of spontaneous breathing and were extubated. Two (9.52%) patients in T-tube group and one (4.76%) patient in PSV group required reintubation within 48 hours. Rate of successful extubation, total time of MV, total time of weaning from MV and total length of stay at ICU and ICU mortality were not statistically significant between two groups.

Conclusion: In patients with simple weaning, T-tube and PSV of 8 cm H2O are suitable methods as SBT for successful liberation from MV