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- Title
Pressure Support Ventilation Versus T-piece as Spontaneous Breathing Trials for Extubation of Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
- Authors
Fonseca, Luiza Mendes; da Câmara, Pedro Matos; Lettieri, Iane Miguel Pereira; Dagostin, Caroline Serafim; de Abreu Vianna, Arthur Oswaldo
- Abstract
Background: Weaning patients with COPD from mechanical ventilation (MV) presents a challenge, as literature on this topic is limited. This study compares PSV and T-piece during spontaneous breathing trials (SBT) in this specific population. Methods: A search of PubMed, EMBASE, and Cochrane in September 2023 yielded four randomized controlled trials (RCTs) encompassing 560 patients. Among these, 287 (51%) used T-piece during SBTs. Results: The PSV group demonstrated a significant improvement in the successful extubation rate compared to the T-piece (risk ratio [RR] 1.14; 95% confidence interval [CI] 1.03–1.26; p = 0.02). Otherwise, there was no statistically significant difference in the reintubation (RR 1.07; 95% CI 0.79–1.45; p = 0.67) or the ICU mortality rates (RR 0.99; 95% CI 0.63–1.55; p = 0.95). Conclusion: Although PSV in SBTs exhibits superior extubation success, consistent weaning protocols warrant further exploration through additional studies.
- Subjects
CHRONIC obstructive pulmonary disease; RANDOMIZED controlled trials; EXTUBATION; ARTIFICIAL respiration; RESPIRATION
- Publication
Lung, 2024, Vol 202, Issue 2, p211
- ISSN
0341-2040
- Publication type
Article
- DOI
10.1007/s00408-024-00678-2