Positive end-expiratory pressure vs T-piece. Extubation after mechanical ventilation.

Abstract:

:Because T-piece breathing may impair oxygenation, the best airway pressure from which to extubate ventilated patients is controversial. We compared the effects of extubation after 1 h of either CPAP 5 and T-piece/ZEEP. Once weaned from mechanical ventilation and breathing spontaneously, 106 patients were randomized to 1 h CPAP or 1 h T-piece/ZEEP, following which patients were extubated and mask O2 administered. No significant difference existed between groups in age, sex, HR, BP, FIO2, PaCO2 or PaO2. However, P(A-a)O2 was significantly greater at 120 min in the CPAP group. Within the CPAP group, P(A-a)O2 was also significantly worse at 120 vs 0 min. Nineteen T-piece patients showed improved P(A-a)O2 at 120 min compared with only ten CPAP patients. Three CPAP and two T-piece patients subsequently required reintubation. This study demonstrates that use of a T-piece dose not impair arterial oxygenation and may in fact be superior to direct extubation from CPAP 5.

journal_name

Chest

journal_title

Chest

authors

Jones DP,Byrne P,Morgan C,Fraser I,Hyland R

doi

10.1378/chest.100.6.1655

subject

Has Abstract

pub_date

1991-12-01 00:00:00

pages

1655-9

issue

6

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)52808-6

journal_volume

100

pub_type

临床试验,杂志文章,随机对照试验

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