Dados do Trabalho

Título

MECHANICAL VENTILATION RECONNECTION FOR ONE HOUR AFTER SPONTANEOUS BREATHING TRIAL: A RANDOMIZED CLINICAL FEASIBILITY TRIAL

Objetivo

To evaluate the feasibility of performing a larger clinical trial to analyze whether reconnection to mechanical ventilation for 1 hour after a successful spontaneous breathing trial reduces the risk of reintubation or death within 7 days in patients with more than 72 hours of mechanical ventilation.

Métodos

This was a randomized feasibility (pilot) non-blinded multicenter trial conducted at four Brazilian hospitals. Critically ill patients admitted to intensive care unit with more than 72 hours of mechanical ventilation and a successful spontaneous breathing trial (on pressure support or T-tube) were randomized into two groups:
1) Reconnection to mechanical ventilation using the previous ventilatory parameters for 1 hour followed by extubation;
2) Extubation immediately after spontaneous breathing trial.

Resultados

From November 2023 to March 2024, 66 patients fulfilled eligibility criteria and were enrolled in the study, as scheduled in advance. One patient was excluded from analysis. Clinical characteristics were similar between groups. The study intervention was performed as assigned in 95% of patients (experimental group 30 [93.7%] vs control group 33 [100%]). Extubation failure (23 [35%]) or death (3 [4.6%]) within 7 days occurred in 35% of patients (experimental group 9 [28%] vs control group 14 [42.4%]; risk difference 14.4; 95% CI -8.5 to 35.3).

Conclusão

This pilot study demonstrated the feasibility of performing a larger clinical trial to analyze whether reconnection to mechanical ventilation for 1 hour after a successful spontaneous breathing trial reduces the risk of reintubation or death within 7 days in patients with more than 72 hours of mechanical ventilation.