Protocol-directed weaning from mechanical ventilation: clinical outcome in patients randomized for a 30-min or 120-min trial with pressure support ventilation

Intensive Care Med. 2002 Aug;28(8):1058-63. doi: 10.1007/s00134-002-1353-z. Epub 2002 Jul 13.


Objective: To investigate the possibility of successful extubation performing a spontaneous breathing trial (SBT) in pressure support ventilation (PSV) with target durations of 30 and 120 min.

Design and setting: Prospective and randomized study in two medical-surgical adult intensive care units.

Patients and participants: 98 adult patients supported by mechanical ventilation for at least 48 h and considered ready for a weaning trial.

Interventions: An SBT conducted in PSV with 7 cmH(2)O and patients randomly assigned to two groups with target durations of 30- and 120-min.

Measurements and results: In the 30-min group 43 patients (93%) tolerated the SBT and were extubated while 4 (9%) needed reintubation within 48 h; in the 120-min group 46 patients (88%) successfully completed the trial and were extubated while 2 (4%) were reintubated. ICU mortality in the groups with short and long periods was 6% and 4%, and in-hospital mortality 20% and 17%, respectively. Those successful in the 30- and 120-min groups had similar length of ICU stay (6 and 7 days, respectively) and in-hospital length of stay (20 and 25 days, respectively). Compared to the successfully extubated, the reintubated patients had significantly higher length of ICU stay and mortality (17 vs. 6 days and 33 vs. 3.6%, respectively).

Conclusions: An SBT with PSV of 7 cmH(2)O lasting 30 min is equally effective in recognizing the successfully extubated patients as a 120-min trial.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Clinical Protocols*
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units / standards*
  • Length of Stay
  • Male
  • Middle Aged
  • Positive-Pressure Respiration*
  • Prospective Studies
  • Switzerland
  • Time Factors
  • Treatment Failure
  • Treatment Outcome
  • Ventilator Weaning / adverse effects
  • Ventilator Weaning / standards*