The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

LENGTH OF SPONTANEOUS BREATHING TRIALS PREDICTS SUCCESFUL VENTILATOR LIBERATION OF LONG-TERM VENTILATED PATIENTS.

Daniel Fisher1, Edward G. Bittner2, Tina Chisholm1, Julie Macpherson-Clements1, Matthias Eikermann2, Ulrich Schmidt1,2; 1Respiratory Care, Massachusetts General Hospital, Boston, MA; 2Anesthesia & Critical Care, Massachusetts General Hospital, Boston, MA

Background: In acutely ill mechanically ventilated patients, a 30 minute spontaneous breathing trial (SBT) has been reported to be predictive of successful liberation from the ventilator. The optimal duration of an SBT in long-term mechanically patients is unknown. Hypothesis: We hypothesized that in long-term ventilated patients a spontaneous breathing trial greater than 30 minutes is required to predict successful liberation from mechanical ventilation Methods: The study was performed in a 10 bed respiratory care unit at Massachusetts General Hospital. 166 consecutive long-term ventilated patients who underwent SBTs between 7/1/08 and 4/15/10 were included in the study. Successful liberation from the ventilator was defined as being of the ventilator for at least 48 hours. Logistic regression analysis was performed to examine the association between SBT duration and successful liberation from the ventilator. Results: Duration of SBT was strongly associated with successful liberation from mechanical ventilation (p < 0.0001). In long-term mechanically ventilated patients an SBT of 2.5 hours was predictive of a 95% probability of successful liberation. A 30 minute SBT was only predictive of 50% probability of successful liberation. Conclusions: In contrast to acutely ventilated patients, in long-term ventilated patients a longer SBT duration is needed for prediction of successful ventilator liberation. Sponsored Research - None