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dc.contributor.authorPellegrini, José Augusto Santospt_BR
dc.contributor.authorBoniatti, Márcio Manozzopt_BR
dc.contributor.authorBoniatti, Viviane M. Corrêapt_BR
dc.contributor.authorZigiotto, Crislene Cattelanpt_BR
dc.contributor.authorViana, Marina Verçozapt_BR
dc.contributor.authorNedel, Wagner Luíspt_BR
dc.contributor.authorMarques, Leonardo da Silvapt_BR
dc.contributor.authorSantos, Moreno Calcagnotto dospt_BR
dc.contributor.authorAlmeida, Clarissa Balbão dept_BR
dc.contributor.authorDal Pizzol, Cláudia Pellizzerpt_BR
dc.contributor.authorZiegelmann, Patricia Klarmannpt_BR
dc.contributor.authorVieira, Silvia Regina Riospt_BR
dc.date.accessioned2019-10-11T03:56:07Zpt_BR
dc.date.issued2018pt_BR
dc.identifier.issn1932-6203pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/200542pt_BR
dc.description.abstractBackground Little is known about the best strategy for weaning patients with chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Spontaneous breathing trials (SBT) using a T-piece or pressure-support ventilation (PSV) have a central role in this process. Our aim was to compare T-piece and PSV SBTs according to the duration of mechanical ventilation (MV) in patients with COPD. Methods Patients with COPD who had at least 48 hours of invasive MV support were randomized to 30 minutes of T-piece or PSV at 10 cm H2O after being considered able to undergo a SBT. All patients were preemptively connected to non-invasive ventilation after extubation. Tracheostomized patients were excluded. The primary outcome was total invasive MV duration. Time to liberation from MV was assessed as secondary outcome. Results Between 2012 and 2016, 190 patients were randomized to T-piece (99) or PSV (91) groups. Extubation at first SBT was achieved in 78% of patients. The mean total MV duration was 10.82 ± 9.1 days for the T-piece group and 7.31 ± 4.9 days for the PSV group (p < 0.001); however, the pre-SBT duration also differed (7.35 ± 3.9 and 5.84 ± 3.3, respectively; p = 0.002). The time to liberation was 8.36 ± 11.04 days for the T-piece group and 4.06 ± 4.94 for the PSV group (univariate mean ratio = 2.06 [1.29±3.27], p = 0.003) for the subgroup of patients with difficult or prolonged weaning. The study group was independently associated with the time to liberation in this subgroup.Conclusions The SBT technique did not influence MV duration for patients with COPD. For the difficult/ prolonged weaning subgroup, the T-piece may be associated with a longer time to liberation, although this should be clarified by further studies.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofPLoS ONE. San Francisco. Vol. 13, no. 8 (Aug. 2018), e0202404, 14 p.pt_BR
dc.rightsOpen Accessen
dc.subjectDoença pulmonar obstrutiva crônicapt_BR
dc.subjectRespiração artificialpt_BR
dc.subjectVentiladores mecânicospt_BR
dc.subjectRespiração com pressão positivapt_BR
dc.subjectEnsaio clínico controlado aleatóriopt_BR
dc.titlePressure-support ventilation or T-piece spontaneous breathing trials for patients with chronic obstructive pulmonary disease : a randomized controlled trialpt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001083774pt_BR
dc.type.originEstrangeiropt_BR


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