Pressure support ventilation mode versus pressure support ventilation+T-piece trial as a weaning modality in mechanically ventilated patients with chronic obstructive pulmonary disease

Abstract

BackgroundPressure support ventilation (PSV) mode and T-piece trial were used in weaning of mechanically ventilated (MV) patients with chronic obstructive pulmonary disease (COPD). Thus, the objective of study is to assess the value of adding T-piece trial to PSV mode in weaning off patients with COPD.Patients and methodsA total of 80 MV patients with COPD admitted to respiratory ICU were divided into two groups: group I included 40 patients who were weaned off by PSV mode and group II included 40 patients who were weaned off by PSV mode and T-piece trial.ResultsThe mean age of patients was 62 years. Overall, 73.8% were males and 73.75% were smokers. There were no significant differences between both groups regarding age, sex, BMI, smoking status, Acute Physiology and Chronic Health Evaluation score, exacerbation frequency, and hospital admission. Moreover, there was no significant differences between both groups regarding vital capacity, negative inspiratory force, rapid shallow breathing index, partial arterial oxygen pressure, partial arterial carbon dioxide pressure, and arterial oxygen saturation at the end of PSV mode in both groups. A significant decline in partial arterial oxygen pressure and arterial oxygen saturation and increase in partial arterial carbon dioxide pressure were observed in group II patients after adding T-piece trial. A total of 34 (85%) patients were successfully extubated in group I, whereas 33 (82.5%) patients were successfully extubated in group II. Period of MV, duration of weaning, ICU stay, and mortality were significantly higher in group II patients.ConclusionT-piece trial after PSV mode has no role in weaning; moreover, it causes more complications and leads to longer duration of weaning.