High-flow oxygen during spontaneous breathing trial for patients at high risk of weaning failure

Excerpt

T-piece spontaneous breathing trial (SBT) often is the final step of mechanical ventilation (MV) weaning to assess whether a patient is eligible for extubation [1]. T-piece SBT is highly demanding in terms of work of breathing and may delay extubation compared to pressure support SBT [2]. Despite the lack of physiological studies, we hypothesized that high-flow oxygen (HFO) therapy might reduce the incidence of hypoxemia and help patients better tolerate the SBT through mild positive end-expiratory pressure and dead-space wash-out effects as demonstrated with nasal HFO (HFNO) in non-intubated patients [3, 4]. We investigated whether SBT with HFO (HFO-SBT) would accelerate MV weaning while not increasing the rate of re-intubation when compared to T-piece SBT in patients at risk for extubation failure. …