Respiratory failure & ventilation
Physiological comparison of high-flow oxygen via endotracheal tube and T-piece strategies during spontaneous breathing trials: a randomized crossover study
Authors' conclusion
During SBT, HFO via endotracheal tube generated flow- and expiratory port diameter-dependent increases in airway pressure and lung volume, with lower dynamic transpulmonary driving pressure and improved oxygenation; no statistically significant difference in ΔPes was observed across HFO, T-piece, and post-extubation measurements.
Study context
- Population
- Patients mechanically ventilated for at least 24 h and deemed ready for weaninganalysed
- Participants
- 20 participants
- Comparison
- High-flow oxygen (HFO) via ETT vs T-piece during spontaneous breathing trial (SBT)
Methodological detailscomplementary bench study
- Complementary bench study
Primary result
As reported in the abstract
Physiological effects vs T-piece
HFO-6.9 at 60 L/min vs T-pieceEstimate (95% CI)
Largest increase
median paired difference, mean expiratory airway pressure 7.0 cm H2O(6.7–7.4)
Largest increase
median paired difference, PEEP 6.0 cm H2O(5.8–6.1)
HFO-6.9 at 60 L/min vs T-pieceMedian paired difference, attenuation of global end-expiratory lung volume loss, mL (95% CI)
Physiological effects vs T-piece
321(267–523)
HFO-6.9 at 60 L/min vs T-pieceMedian paired difference, improvement in PaO2/FiO2, mmHg (95% CI)
Physiological effects vs T-piece
28(14–52)
- Physiological effects vs T-piece
- median paired difference, reduction in dynamic transpulmonary driving pressure 3.3 cm H2O (95% CI 1.8–4.1)
- Physiological effects vs T-piece
- median paired difference, reduction in respiratory rate 2 breaths/min (95% CI 1–4)
Further findings
Inspiratory effort (ΔPes) across 5 SBT conditions and post-extubation
- No statistically significant difference in ΔPes across the five SBT conditions and post-extubation measurements
- P = 0.24
Bench study (24 simulated conditions)
- Bench simulations supported the flow- and diameter-dependent pressure effects
Original publication
Physiological comparison of high-flow oxygen via endotracheal tube and T-piece strategies during spontaneous breathing trials: a randomized crossover study. Crit Care. Published 18 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →