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

被引：2

作者：

Fonseca, Luiza Mendes ^{[1
]}

da Camara, Pedro Matos ^{[2
]}

Lettieri, Iane Miguel Pereira ^{[3
]}

Dagostin, Caroline Serafim ^{[3
]}

Vianna, Arthur Oswaldo de Abreu ^{[4
]}

机构：

[1] Fac Med Sci Minas Gerais, Dept Med, Inconfidentes St 443, BR-1102 Belo Horizonte, MG, Brazil

[2] Univ Fed Rio Grande do Norte, Dept Med, Natal, RN, Brazil

[3] Univ Extreme South Santa Catarina, Dept Med, Criciuma, SC, Brazil

[4] Clin Sao Vincente, ICU, Rio De Janeiro, Brazil

来源：

LUNG | 2024年 / 202卷 / 02期

关键词：

Mechanical ventilation; Ventilator weaning; Extubation; Chronic obstructive Pulmonary disease; Randomized controlled trials; Meta-analysis; MECHANICAL VENTILATION; FAILURE;

D O I：

10.1007/s00408-024-00678-2

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

BackgroundWeaning 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.MethodsA 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.ResultsThe 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).ConclusionAlthough PSV in SBTs exhibits superior extubation success, consistent weaning protocols warrant further exploration through additional studies.

引用

页码：211 / 216

页数：6

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