Evaluation of the spontaneous breathing trial in burn intensive care patients

Burns. 2009 Aug;35(5):665-71. doi: 10.1016/j.burns.2008.12.005. Epub 2009 Mar 20.

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 >24h 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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Burns / pathology
  • Burns / physiopathology
  • Burns / therapy*
  • Critical Care / methods*
  • Humans
  • Intubation, Intratracheal
  • Length of Stay / statistics & numerical data
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Respiration*
  • Respiration, Artificial
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Ventilator Weaning / methods*