A SBT-based Protocol-directed Program in Difficult-to-Wean Patients

A Spontaneous Breathing Trial-based Protocol-directed Program in Difficult-to-Wean Patients

Weaning patients from a ventilator is one of the most challenging processes in an intensive care unit. The investigators aimed to determine whether spontaneous breathing trial (SBT)-based protocol-directed weaning combined with the high-flow nasal cannula (HFNC) could be superior to routine SBT-based weaning in reducing the duration of mechanical ventilation (MV) in difficult-to-wean patients.

Inclusion Criteria:

• age ≥ 16 years old
• MV for more than 48 hours
• intubated or tracheostomized

Exclusion Criteria:

• pregnancy
• irreversible respiratory failure caused by neurodegenerative disorders, such as Alzheimer disease, motor neuron disease, or multiple system atrophy
• pre-existing decision to limit life support
• waiving of MV during treatment
• terminal stage of severe illness