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Meta-Analysis
. 2024 Apr;202(2):211-216.
doi: 10.1007/s00408-024-00678-2. Epub 2024 Mar 12.

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

Luiza Mendes Fonseca  1 , Pedro Matos da Câmara  2 , Iane Miguel Pereira Lettieri  3 , Caroline Serafim Dagostin  4 , Arthur Oswaldo de Abreu Vianna  5   6
Affiliations
Meta-Analysis

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

Luiza Mendes Fonseca et al. Lung. 2024 Apr.

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.

Keywords: Chronic obstructive Pulmonary disease; Extubation; Mechanical ventilation; Meta-analysis; Randomized controlled trials; Ventilator weaning.

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References

    1. Ely EW, Baker AM, Dunagan DP, Burke HL, Smith AC, Kelly PT et al (1996) Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 335(25):1864–1869 - DOI - PubMed
    1. Santos Pellegrini JA, Boniatti MM, Boniatti VC, Zigiotto C, Viana MV, Nedel WL et al (2018) Pressure-support ventilation or T-piece spontaneous breathing trials for patients with chronic obstructive pulmonary disease - A randomized controlled trial. PLoS ONE 13(8):e0202404 - DOI - PubMed - PMC
    1. Kuhlen R, Max M (1998) Die Entwöhnung von der Beatmung. Teil 2. Anaesthesist 47(8):693–703 - DOI - PubMed
    1. Zein H, Baratloo A, Negida A, Safari S (2016) Ventilator Weaning and Spontaneous Breathing Trials; an Educational Review. Emerg (Tehran) 4(2):65–71 - PubMed
    1. Li Y, Li H, Zhang D (2020) Comparison of T-piece and pressure support ventilation as spontaneous breathing trials in critically ill patients: a systematic review and meta-analysis. Crit Care 24(1):67 - DOI - PubMed - PMC

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