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

期刊论文
发表日期：

2024年3月12日

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Luiza Mendes Fonseca,
Pedro Matos da Câmara,
Iane Miguel Pereira Lettieri,
Caroline Serafim Dagostin,
Arthur Oswaldo de Abreu Vianna

摘要

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.