Less-Taxing Spontaneous Breathing Trial Was Better for Liberating Patients from the Ventilator

The spontaneous breathing trial (SBT) is the standard of care for assessing readiness to be liberated from mechanical ventilation; however, SBTs vary in duration (30–120 minutes) and degree of ventilatory support. The most common options are a T-piece, which provides only supplemental oxygen through the endotracheal tube, or low-level pressure support ventilation (PSV) to overcome the tube's resistance. Investigators in Spain randomized 1150 mechanically ventilated patients who met specific weaning criteria to SBTs that were less demanding (30 minutes of PSV with 8-cm H₂O pressure support and no positive end-expiratory pressure; PSV group) or highly demanding (120 minutes of T-piece ventilation; T-piece group). Criteria for SBT failure incl…