Evaluation of the spontaneous breathing trial in burn intensive care patients.
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.
Smailes
Sarah T
ST
St. Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford CM1 7ET, United Kingdom. sarah.smailes@meht.nhs.uk
Martin
Rebecca V
RV
McVicar
Andrew J
AJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D002056:Burns / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012119:Respiration; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods*