Diagnostic approach to the failure of spontaneous breathing trial during mechanical ventilation weaning process

Abstract

During mechanical ventilation weaning process, several mechanisms could lead to the failure of spontaneous breathing trial. Early identification of the reasons, mostly respiratory, cardiovascular or neuromuscular, is essential since it may result in a specific therapeutic management. Clinical examination, cardiovascular monitoring, transthoracic echocardiography, changes induced by spontaneous breathing trial in biological variables like plasma protein concentration, haemoglobin or B-type natriuretic peptide, and bedside electromyographic recording allow this crucial physiopathological analysis, which represents the basis of therapeutic care.