The effect of spontaneous breathing trial in extubation in chronic obstructive pulmonary disease patients

Objective:To study the effects of spontaneous breathing trial (SBT) in the discontinuing period in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients. Method: Twenty-six COPD patients with protocol-driven extubalion strategy with SBT as SBT group (male 19, female 7) were included in the study. Twenty-eight COPD patients (male 24, female 4) without SBT as No-SBT group were retrospected. Duration of mechanical ventilation, reintubation rate (48h after extubation), duration of extubation, PaO_2, PaCO_2, levels of blood albumin and hemoglobin were compared between the two groups. Result: All the patients in the two groups were similar in age (P=0.683) and mechanical ventilation duration (P=0.167). However, the extubation duration in SBT group (60 min) was significantly different from that (40-540min) in No-SBT group (P=0.0001). In SBT group, 2 patients who failed within 1-hr SBT were excluded from the study. In each group, there were 3 patients required noninvasive ventilation following extubation (P=0.717). Two (2/24) patients in SBT group and 3 (3/28) patients in No-SBT group needed reintubation (P=0.900). Conclusion: The protocol-driven spontaneous breathing trial may shorten the extubation duration in mechanically ventilated COPD patients. Meanwhile, the rale of reintubation does not increased.