Spontaneous breathing trial

Abstract

Spontaneous breathing trial (SBT) is a key element during the process of weaning from mechanical ventilation. The objective of SBT is to mimic conditions of ventilation after extubation and thus to help clinicians to predict the result of a decision of extubation. When predefined criteria are met, a systematic daily SBT allows to decrease the duration of mechanical ventilation. Several methods and durations of SBT have been studied. The work of breathing is higher during SBT performed with T-piece ventilation than during SBT performed in pressure support ventilation. SBT in pressure support ventilation is associated with a higher success rate than SBT with T-piece ventilation, without increased risk of reintubation.  The choice of method and duration of SBT should be determined as part of a comprehensive strategy considering the patient’s characteristics and the time of SBT in the weaning process.