In an SBT, a safety screening first ensures that your patient is ready for a breathing trial that day.1,2 If he or she passes the screen, you may consider adjusting the ventilator to provide no or reduced breathing support (less than 7 cmH2O inspiratory pressure), for example, via pressure support, continuous positive airway pressure (CPAP) or ventilation with a T-piece.1,2 Monitor respiration, oxygen saturation, and mental and cardiac status closely.1,2 If your patient shows no significant signs of distress after a predefined period, the test is usually considered successful and extubation may be considered.1,2 If the patient shows signs of difficulty, additional ventilatory support may be resumed.1,2
Ideally the SBT is done while your patient is awake and not under sedation.6 There is evidence that patients who are given sedation holidays prior to SBT are more likely to pass the breathing trial.1,2 Those patients may also leave the ICU sooner and show lower mortality one year later, compared to controls who had daily SBTs without daily sedation breaks.1,2
Together with sedation holidays, spontaneous breathing trials may help you to ensure safe, early liberation from mechanical ventilation and better outcomes for your patients.1,2,6 The resources below provide more information, and can help you design a program that meets the needs of your patients and caregivers.
