Respiratory failure & ventilation
Spontaneous Breathing Trial Techniques for Extubating Adults and Children Who Are Critically Ill: A Systematic Review and Meta-Analysis
Authors' conclusion
In this systematic review and meta-analysis, the findings suggest that patients undergoing PS compared with T-piece SBTs were more likely to be extubated successfully and more likely to pass an SBT, after exclusion of an outlier trial.
Study context
- Population
- Critically ill adults or children undergoing spontaneous breathing trial (SBT) before extubation
- Participants
- 6,716 adults · 40 trials
- Comparison
- Alternative SBT techniques
- Outcome
- SBT success, extubation success, and reintubation
Methodological detailsrandom-effects models, PRISMA
- Random-effects models
- PRISMA
Pooled result
As reported in the abstract
SBT success, PS vs T-piece
PS vs T-pieceRR for passing the SBT (95% CI)P value
I2 = 73%; 14 trials [n = 4459]; low-quality evidence
1.04(0.97–1.11)
P = 0.311 outlier trial excluded; I2 = 0% [13 trials; n = 3939]; moderate-quality evidence
1.09(1.06–1.12)
P < 0.001Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| Successful extubation, PS vs T-pieceI2 = 0%; 16 trials [n = 4462]; moderate-quality evidence | RR for successful extubation 1.07 (95% CI 1.04–1.10) | P < 0.001 | |
| Successful extubation, automatic tube compensation/CPAP vs PSI2 = 0%; 5 trials [n = 502]; low-quality evidence | RR for successful extubation 1.10 (95% CI 1.00–1.21) | P = 0.04 | |
| Successful extubation, high-flow oxygen vs T-pieceI2 = 0%; 3 trials [n = 386]; low-quality evidence | RR for successful extubation 1.06 (95% CI 1.00–1.11) | P = 0.04 | |
| Reintubation, high-flow oxygen vs T-pieceI2 = 0%; 3 trials [n = 386]; low-quality evidence | RR for reintubation 0.37 (95% CI 0.21–0.65) | P = <.001 | |
| 0.20.5125Ratio (log scale) |
Subgroups (subgroup)
- Credible subgroup effects were not found
Original publication
Spontaneous Breathing Trial Techniques for Extubating Adults and Children Who Are Critically Ill: A Systematic Review and Meta-Analysis. JAMA Netw Open. Published 5 February 2024. doi:10.
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