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- Title
Weaning strategy in patients at low-to-medium risk of extubation failure. Author's reply.
- Authors
Hernández, Gonzalo; Rodriguez, Patricia
- Abstract
This document is a reply to a letter regarding a trial published in the journal Intensive Care Medicine. The authors address concerns raised by the letter writer about the protocol and interpretation of the trial results. They explain that the population analyzed in the trial was randomized to a spontaneous breathing trial, and the weaning rate and time to extubation were outcomes rather than baseline characteristics. The authors also discuss possible explanations for the higher incidence of reintubation in the aggressive-aggressive group, including the use of positive end-expiratory pressure during the trial. They argue that the study's design and protocol reduce the risk of treatment bias. The authors disagree with the letter writer's opinion that time to extubation is determined solely by screening and reintubation by the trial, and they emphasize the complexity of reintubation as a phenomenon. They also address concerns about different management practices for post-extubation respiratory failure and the risk of treatment bias. The authors conclude by stating that their study's design and protocol prevent treatment bias and reduce the risk of increased mortality. They also note that their protocol prevented reaching the conservative screening criteria earlier than the aggressive screening criteria. The document does not have any funding or data availability information. The authors disclose a conflict of interest related to travel expenses and personal fees from Fisher & Paykel Healthcare Ltd.
- Subjects
EXTUBATION; POSITIVE end-expiratory pressure
- Publication
Intensive Care Medicine, 2024, Vol 50, Issue 6, p999
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-024-07427-2