Pediatric anesthesia & critical care
A 30-Minute Spontaneous Breathing Trial Misses Many Children Who Go On to Fail a 120-Minute Spontaneous Breathing Trial
Authors' conclusion
A 30-min SBT may be too short in children recovering from pediatric ARDS because many go on to fail between 30 and 120 min.
Study context
- Population
- Children with pediatric ARDS undergoing daily 2-h spontaneous breathing trials (SBTs)
- Participants
- 100 children · 305 SBTs
- Primary endpoint
- SBT outcome (passage, early failure ≤ 30 min, late failure 30-120 min) and prediction by parameters at 30 min
- Follow-up
- 30 min
Methodological detailsprognostic modelling, independent validation set
- Prognostic modelling
- Independent validation set
Primary result
As reported in the abstract
SBT outcome and 30-min prediction
- SBTs successful
- 42%
- SBTs failing within 30 min
- 32%
- SBTs failing between 30 and 120 min
- 25%
- Patients passing SBTs at 30 min who failed by 120 min
- 40%
- Multivariable model AUC in independent validation set (ROC plot crossing reference line)
- 0.67
Further findings
High respiratory effort (esophageal manometry) in failed SBTs
- Present in failed SBTs
- > 80%
Predictors of SBT failure (multivariable model)
- RR at 30 min
- P < 0.001
- Rapid shallow breathing index (RSBI) > 7 at 30 min
- P = 0.034
- Pre-SBT inspiratory pressure level
- P = 0.009
- Pre-SBT retractions
- P = 0.042
Original publication
A 30-Minute Spontaneous Breathing Trial Misses Many Children Who Go On to Fail a 120-Minute Spontaneous Breathing Trial. Chest. Published 28 August 2022. doi:10.
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