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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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