Evaluation of the spontaneous breathing trial in burn intensive care patients |
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Authors: | Sarah T Smailes RebeccaV Martin Andrew J McVicar |
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Institution: | 1. St. Andrew''s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford CM1 7ET, United Kingdom;2. Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM1, United Kingdom |
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Abstract: | BackgroundThe extubation failure rate in our burn patients is 30%.ObjectiveTo evaluate the influence of the 30 min spontaneous breathing trial on extubation outcome in burn patients.MethodsA prospective, observational study in a burn intensive care unit. All adult patients requiring mechanical ventilation for >24 h and meeting the inclusion criteria underwent a 30 min spontaneous breathing trial (SBT). Extubation was undertaken after a successful SBT.ResultsOf 49 planned extubations, 9 failed (18%), much lower than the 30% extubation failure rate identified prior to the implementation of the SBT. The duration of ventilation was significantly shorter (p = 0.04) in the patients who passed a SBT and those who failed extubation were significantly older (p = 0.003). The logistic regression analysis identified that age independently predicted extubation outcome. Patients who failed extubation, after a successful SBT, had a significantly longer duration of ventilation (p = 0.0001) and ITU length of stay (p = 0.001).ConclusionsThe incidence of extubation failure was much lower and the duration of ventilation significantly shorter in patients who were extubated after a successful SBT. These findings support the use of the SBT in burn patients. Age independently predicts extubation outcome in burn patients who have passed a SBT. |
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Keywords: | Ventilation Extubation Spontaneous breathing trial |
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