Respiratory failure & ventilation
Assessment of Respiratory Mechanics and Inspiratory Effort During Spontaneous Breathing Trials to Predict Extubation Failure in High-Risk Patients
Authors' conclusion
In high-risk patients, SBT-induced declines in respiratory system compliance and increases in inspiratory effort are associated with extubation failure.
Study context
- Population
- Patients at high risk of extubation failure who passed a 30-minute SBT on conventional parametersextubated
- Participants
- 238 patients
- Comparison
- Success vs Failure
- Failuren = 46
- Outcome
- SBT-induced changes in respiratory mechanics and inspiratory effort, and extubation failure
Methodological detailsmulticentre
- Multicentre
Performance
As reported in the abstract
- Reintubation within 72 hours (extubation failure)
- 46 (19%) of 238
- Failure: normalized compliance declined during SBT, ml/cm H2O/kg
- 1.0 [0.8-1.2] to 0.7 [0.6-0.9]; P < 0.001
- Failure: inspiratory effort increased during SBT, cm H2O
- 12 [10-15] to 18 [15-20]; P < 0.001
- P0.1 increased in both groups, more markedly in reintubated patients, cm H2O
- 2 [1.5-2.4] to 3.2 [2.9-3.5]; P < 0.001
- Normalized compliance reduction ≤ −0.2 ml/cm H2O/kg predicting extubation failure: AUC (sensitivity, specificity)
- 0.90 [0.84-0.93] (80%, 83%)
- Inspiratory effort increase >2 cm H2O predicting extubation failure: AUC (sensitivity, specificity)
- 0.94 [0.90-0.97] (89%, 93%)
Further findings
| Outcome | Failure |
|---|---|
| P0.1 during SBT | median 2 to 3.2 (IQR 1.5-2.4 to 2.9-3.5) cm H2O |
- Normalized compliance during SBT, Failure
- 1.0 to 0.7 · median · IQR 0.8-1.2 to 0.6-0.9 · ml/cm H2O/kg
- Inspiratory effort during SBT, Failure
- 12 to 18 · median · IQR 10-15 to 15-20 · cm H2O
- Normalized compliance during SBT, Failure: P < 0.001
- Inspiratory effort during SBT, Failure: P < 0.001
- P0.1 during SBT: P < 0.001
Normalized compliance during SBT, Failure
- Unchanged in success group
Inspiratory effort during SBT, Failure
- Unchanged in success group
P0.1 during SBT
- Increased in both groups, more markedly in reintubated
Vt and respiratory rate
- No differences between groups at any time
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Assessment of Respiratory Mechanics and Inspiratory Effort During Spontaneous Breathing Trials to Predict Extubation Failure in High-Risk Patients. Am J Respir Crit Care Med. Published 1 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →