The Best Way to Do a Spontaneous Breathing Trial

Invasive mechanical ventilation can be lifesaving, but it also confers risks. Liberating a patient from a ventilator is a priority in the intensive care unit (ICU). One key to this process is the spontaneous breathing trial (SBT) — a short period of time when a patient is observed while receiving minimal ventilator support. In two recent papers, researchers examined different approaches to SBTs.

Investigators performed a meta-analysis of 22 randomized trials (>6000 patients) that compared approaches to SBTs and their effects on risk for reintubation. Duration and degree of ventilatory support during SBTs varied widely. Rates of reintubation among patients in T-piece (no ventilatory support) and pressure-supported trials were similar. SBTs do…