Spontaneous Breathing Trial with Pressure Support-Ventilation versus “T-Tube” for Head Trauma Patient: A Randomized Controlled Clinical Trial

Abstract

Background: Assessing patients’ readiness for weaning through spontaneous breathing trial (SBT) is a reliable method for improving weaning and extubation outcomes. Until now, there are controversies over the best SBT method. Objective: This study aimed to compare the clinical outcomes of the T-piece and pressure support ventilation (PSV) SBT methods among patients with traumatic brain injury. Methods: In this randomized controlled trial, 72 patients under mechanical ventilation were purposively recruited from the intensive care unit of Shahid Rajaei hospital, Qazvin, Iran, and randomly allocated to an intervention and a control group. SBT was conducted in the intervention and control groups through the T-piece and PSV (with pressure support of less than 8 cm H2O), respectively. The groups were compared with each other respecting weaning outcomes, extubation success, length of mechanical ventilation, length of hospital stay, and mortality rate. Data were compared using the Chi-square and the independent-sample t-tests. Results: Weaning success rate in the T-piece group was significantly greater than the PSV group (P=0.024), while the post-weaning length of hospital stay in the T-piece group was significantly shorter than the PSV group (P=0.05). There were no significant differences in respecting extubation success rate and length of mechanical ventilation between the groups (P>0.05). Conclusion: The T-piece method for SBT could be better tolerated by patients with traumatic brain injury compared with PSV.