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ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 1  |  Page : 37-41

Comparison of extubation outcomes following T-piece trial versus pressure support/continous positive airway pressure in postsurgical patients


Department of Anesthesia and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

Correspondence Address:
Dr. Lakshmi Kumar
Department of Anesthesia and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi - 682 024, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijrc.ijrc_25_17

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Background: Pressure support with continuous positive airway pressure (CPAP) and T-piece trials are the most common spontaneous breathing trial used to test readiness for extubation. Aim: We aimed to compare extubation failures defined by the need for reintubation within 48 h following T-piece trial versus extubation directly from pressure support (PS) ventilation in postoperative patients. Patients and Methods: This was a prospective cross-sectional study conducted in the postsurgical patients. Hemodynamic parameters and respiratory variables were measured before and after weaning trials. Outcomes after extubation, need for noninvasive-assist ventilation following extubation, duration of oxygen therapy, and time of shifting from the Intensive Care Unit (ICU) were also recorded. Results: Fifty patients needed mechanical ventilation postoperatively were recruited for the study. No significant differences were seen in the rate of extubation failures between PS- and T-piece groups. Rapid shallow breathing index recorded at the start of weaning was significantly higher in the T-piece group (P < 0.001). The respiratory rate (RR) and heart rate (HR) were significantly higher (P < 0.001) and saturation lower (P = 0.035) in the group on T-piece trial. The need for respiratory assist devices, oxygenation index, length of ICU stay, duration of oxygen therapy, and mortality were comparable between the two groups. Conclusions: Outcomes of weaning are similar between T piece and CPAP/PS in patients undergoing postoperative mechanical ventilation. Weaning on T piece is associated with higher RR, HR, rapid shallow breathing, and lower saturation than weaning from CPAP/PS but does not affect the length of ICU stay, need for oxygen therapy, or mortality.


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