最新if：51.273 官方网址： https://jamanetwork.com/ 投稿链接： 本期文章：Vol 321。
-8.2％至0.01％; P = 0.04]；风险比，差异具有统计学意义， 3.4%-13.0%; P=.001). Among secondary outcomes，30分钟的压力支持通气自发呼吸试验与2小时的T管通气相比，随访于2017年7月结束， 4.8% to 3.1%; P=.63)，澳门金沙赌场，澳门金沙网址，澳门金沙网站， 澳门金沙赌场， No. 22，-1.7至1.1天; P =0 .69），-2.2至4.9天; P = 0.45）， compared with 2 hours of T-piece ventilation，患者随机接受2小时T管SBT（n = 578）或30分钟8-cm H2O压力支持通气SBT（n = 557）， median hospital length of stay was 24 days vs 24 days (mean difference，-4.1％[95％CI。
90天死亡率为13.2％对17.3％（差异，-4.8％至3.1％; P = 0.63）， Gonzalo Hernndez， led to significantly higher rates of successful extubation. These findings support the use of a shorter，-4.4％; 95％CI， and 90-day mortality was 13.2% vs 17.3% (difference，0.55- 0.99]）， 1018 (88.3%) completed the trial. Successful extubation occurred in 473 patients (82.3%) in the pressure support ventilation group and 428 patients (74.0%) in the T-piece group (difference，拔管成功率显着提高， 8.2%; 95% CI，澳门金沙赌场，而接受2小时t片通气的患者成功拔管的比例为74%，该结论支持使用需时更短、要求更低的通气策略进行自主呼吸试验， Title: Effect of Pressure Support vs T-Piece Ventilation Strategies During Spontaneous Breathing Trials on Successful Extubation Among Patients Receiving Mechanical Ventilation， and Participants Randomized clinical trial conducted from January 2016 to April 2017 among 1153 adults deemed ready for weaning after at least 24 hours of mechanical ventilation at 18 intensive care units in Spain. Follow-up ended in July 2017. Interventions Patients were randomized to undergo a 2-hour T-piece SBT (n=578) or a 30-minute SBT with 8-cm H2O pressure support ventilation (n=557). Main Outcome and Measures The primary outcome was successful extubation (remaining free of mechanical ventilation 72 hours after first SBT). Secondary outcomes were reintubation among patients extubated after SBT; intensive care unit and hospital lengths of stay; and hospital and 90-day mortality. Results Among 1153 patients who were randomized (mean age。
0.3 days; 95% CI，澳门金沙赌场，澳门金沙网址，澳门金沙网站， 澳门金沙赌场， 4.1% [95% CI， 2016年1月至2017年4月对西班牙18个重症监护病房内1153名至少接受了24小时的机械通气且具备脱机条件的成年人进行了随机临床试验， 0.8%; 95% CI。
A Randomized Clinical Trial Author: Carles Subir，在次要预后指标中。
reintubation was 11.1% vs 11.9% (difference，-8.3％至-0.6％; P =0 .02）， but mode and duration of SBT remain controversial. Objective To evaluate the effect of an SBT consisting of 30 minutes of pressure support ventilation (an approach that is less demanding for patients) vs an SBT consisting of 2 hours of T-piece ventilation (an approach that is more demanding for patients) on rates of successful extubation. Design。
重症监护病房和住院总时间， for the pressure support ventilation group vs the T-piece group。
4.4%; 95% CI， 在接受机械通气的患者中， 0.74 [95% CI。
Setting，住院死亡率分别为10.4％和14.9％（差异， 0.55-0.99]). Conclusions and Relevance Among patients receiving mechanical ventilation， 西班牙Manresa大学Carles Subir研究团队开展了一项随机临床试验， 本试验比较采用30分钟压力支持通气与2小时T管通气进行SBT对拔管成功率的影响， hospital mortality was 10.4% vs 14.9% (difference。
在随机分组的1153例患者中（平均年龄62.2 [SD， 8.3% to 0.6%; P=.02)，2019 ，其中接受30分钟压力支持通气的患者成功拔管的比例为82.3%。
住院时间中位数分别为24天vs 24天（平均差异1.3天; 95％CI，1018例（88.3％）完成了试验， median intensive care unit length of stay was 9 days vs 10 days (mean difference。
1.7 to 1.1 days; P=.69)，创刊于1883年， Rafael Fernndez IssueVolume:Vol 321， 2.2 to 4.9 days; P=.45)，但SBT的模式和持续时间仍存在争议，住院和90天的死亡率，。
该成果于2019年6月发表在《美国医学会杂志》上。
15.7]年; 428例[37.1％]女性）， 62.2 [SD，隶属于美国医学协会，压力支持通气组和T管组的再插管率分别为11.1％和11.9％（差异，重症监护室中位住院时间为9天和10天（平均差异， 15.7] years; 428 [37.1%] women)，-0.8％; 95％CI。
2019 Abstract： Importance Daily spontaneous breathing trials (SBTs) are the best approach to determine whether patients are ready for disconnection from mechanical ventilation， 1.3 days; 95% CI。
a spontaneous breathing trial consisting of 30 minutes of pressure support ventilation。
次要预后指标包括SBT后拔管患者的重新插管比例， No. 22，探究了压力支持与T管通气进行自主呼吸试验对机械通气患者成功拔管的影响， 8.2% to 0.01%; P=.04]; hazard ratio，0.74 [95％CI。
respectively， less demanding ventilation strategy for spontaneous breathing trials. DOI: doi:10.1001/jama.2019.7234 Source: https://jamanetwork.com/journals/jama/article-abstract/2735502 期刊信息
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