Spontaneous Breathing Trial with Pressure Support-Ventilation versus “T-Tube” for Head Trauma Patient: A Randomized Controlled Clinical Trial

Background: Assessing patients’ readiness for weaning through spontaneous breathing trial (SBT) is a reliable method for weaning and extubation of patients. Until now, there are controversies regarding the best SBT method. Objective: This study sought to compare the clinical outcomes of the T-piece and pressure support ventilation (PSV) SBT methods among patients with traumatic brain injury. Methods: In this randomized controlled trial, 72 patients under mechanical ventilation were recruited from the intensive care unit of Shahid Rajaei hospital, Qazvin, Iran, and randomly allocated to an intervention or control group. SBT was conducted in the study group. In the control group, it was done through the T-piece and PSV (with pressure support of less than 8 cm H2O), respectively. The groups were compared with each other respecting weaning outcomes, extubation success, length of mechanical ventilation, length of hospital stay, and mortality rate. Data were compared using the Chi-square and the independent-sample t-tests. Results: Weaning success rate in the T-piece group was significantly greater than the PSV group (P=0.024), while the post-weaning length of hospital stay in the T-piece group was significantly shorter than the PSV group (P=0.05). There were no significant differences in extubation success rate and length of mechanical ventilation between the groups (P>0.05). Conclusion: The T-piece method for SBT could be better tolerated by patients with traumatic brain injury compared with PSV.