Evaluation of the spontaneous breathing trial in burn intensive care patients

Abstract

Background The extubation failure rate in our burn patients is 30%. Objective To evaluate the influence of the 30 min spontaneous breathing trial on extubation outcome in burn patients. Methods A prospective, observational study in a burn intensive care unit. All adult patients requiring mechanical ventilation for >24 h and meeting the inclusion criteria underwent a 30 min spontaneous breathing trial (SBT). Extubation was undertaken after a successful SBT. Results Of 49 planned extubations, 9 failed (18%), much lower than the 30% extubation failure rate identified prior to the implementation of the SBT. The duration of ventilation was significantly shorter ( p = 0.04) in the patients who passed a SBT and those who failed extubation were significantly older ( p = 0.003). The logistic regression analysis identified that age independently predicted extubation outcome. Patients who failed extubation, after a successful SBT, had a significantly longer duration of ventilation ( p = 0.0001) and ITU length of stay ( p = 0.001). Conclusions The incidence of extubation failure was much lower and the duration of ventilation significantly shorter in patients who were extubated after a successful SBT. These findings support the use of the SBT in burn patients. Age independently predicts extubation outcome in burn patients who have passed a SBT.