title: Different spontaneous breathing trials in patients with atrial fibrillation.
abstract: BACKGROUND
  Weaning from mechanical ventilation is one of the most important and challenging problems for most intensive care unit (ICU) patients. Spontaneous breathing trial (SBT) is the most common method used to evaluate patients' ability to breathe by themselves and plays an important role in decision making for weaning. The aim of our study was to investigate the effect of different methods of SBT in respiratory care unit (RCU) patients with atrial fibrillation (AF) on weaning outcome.
  
  
  METHODS
  We retrospectively analyzed different methods of SBT in patients with and without AF. We enrolled RCU patients who required mechanical ventilation and had undergone transthoracic echocardiography from January 2011 to January 2012.
  
  
  RESULTS
  There was a higher SBT passing rate among AF patients who received pressure support ventilation (PSV) trial than in those who received T-piece trail (92.5% vs. 73.1%, p=0.041). The weaning rates between these two groups were not significantly different (83.8% vs. 94.7%, p=0.403). Total ventilator days were longer in T-piece group than in PSV group (median 40.0, IQR: 18.2-125.1 days vs. 33.0, IQR: 29.6-51.0 days respectively, p=0.580), but this difference was not statistically significant. These results were not found in patients without AF.
  
  
  CONCLUSIONS
  The use of PSV trial might be considered first instead of T-piece trial for SBT when AF patients were ready to wean.
authors.affiliation: Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taiepi, Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Tseng
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Tseng
authors.affiliation: Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taiepi, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: H-S
authors.initials: HS
authors.lastname: Hsu
authors.affiliation: Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taiepi, Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: scchang@vghtpe.gov.tw.
authors.forename: S-C
authors.initials: SC
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D012119:Respiration; D012121:Respiration, Artificial; D012189:Retrospective Studies; D015300:Ventilator Weaning
keywords: Atrial fibrillation (AF); Intensive care unit (ICU); Mechanical ventilation; Spontaneous breathing trial (SBT); Ventilator weaning