Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial
Background: A spontaneous breathing trial (SBT) is often used to decide about extubation readiness in mechanically ventilated patients. Studies done to identify the best method of SBT have shown variable results. As there was no published data comparing continuous positive airway pressure (CPAP) and...
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2021-01-01
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doaj-561de04fa031424a9892562823b214022021-06-02T09:53:39ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992021-01-018312312710.4103/jpcc.jpcc_191_20Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trialRamesh Chand BairwaHiremath SagarAnil Kumar SapareRajiv AggarwalBackground: A spontaneous breathing trial (SBT) is often used to decide about extubation readiness in mechanically ventilated patients. Studies done to identify the best method of SBT have shown variable results. As there was no published data comparing continuous positive airway pressure (CPAP) and T piece, this study was conducted to compare CPAP and T piece as method of SBT for postextubation outcomes. Subjects and Methods: This study was a pilot randomized controlled trial conducted at a tertiary care pediatric intensive care unit (PICU) from November 2018 to October 2019. Criteria for starting SBT and to identify trial as failure were predefined. Sixty patients were included in the study and randomly assigned to CPAP and T-piece group, of 30 each. Demographic data, diagnosis, duration of mechanical ventilation (MV), endotracheal tube size, need of inotropes, vasopressors, and sedation were all recorded. The primary outcome of the study was extubation failure within 48 h. The secondary outcomes studied were mortality, need of respiratory support, duration of oxygen requirement, and length of PICU (LOPICU) stay after extubation. Results: Age, gender, indication of intubation, duration of MV, and number of SBT attempts were similar in both the groups. There was no statistically significant difference in extubation failure within 48 h between the two groups. Four patients were reintubated in both the groups and two patients died in T piece group and one patient in CPAP group. Postextubation respiratory support, duration of oxygen therapy, LOPICU stay, and mortality were not significant different between the two groups. Conclusion: There was no significant difference in extubation outcomes when CPAP and T piece were used as methods of SBT.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=3;spage=123;epage=127;aulast=Bairwacontinuous positive airway pressurepediatric intensive care unitspontaneous breathing trialt piece |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ramesh Chand Bairwa Hiremath Sagar Anil Kumar Sapare Rajiv Aggarwal |
spellingShingle |
Ramesh Chand Bairwa Hiremath Sagar Anil Kumar Sapare Rajiv Aggarwal Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial Journal of Pediatric Critical Care continuous positive airway pressure pediatric intensive care unit spontaneous breathing trial t piece |
author_facet |
Ramesh Chand Bairwa Hiremath Sagar Anil Kumar Sapare Rajiv Aggarwal |
author_sort |
Ramesh Chand Bairwa |
title |
Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial |
title_short |
Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial |
title_full |
Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial |
title_fullStr |
Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial |
title_full_unstemmed |
Comparison between continuous positive airway pressure and T piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: A pilot randomized control trial |
title_sort |
comparison between continuous positive airway pressure and t piece as spontaneous breathing trial at a tertiary care pediatric intensive care unit: a pilot randomized control trial |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Pediatric Critical Care |
issn |
2349-6592 2455-7099 |
publishDate |
2021-01-01 |
description |
Background: A spontaneous breathing trial (SBT) is often used to decide about extubation readiness in mechanically ventilated patients. Studies done to identify the best method of SBT have shown variable results. As there was no published data comparing continuous positive airway pressure (CPAP) and T piece, this study was conducted to compare CPAP and T piece as method of SBT for postextubation outcomes.
Subjects and Methods: This study was a pilot randomized controlled trial conducted at a tertiary care pediatric intensive care unit (PICU) from November 2018 to October 2019. Criteria for starting SBT and to identify trial as failure were predefined. Sixty patients were included in the study and randomly assigned to CPAP and T-piece group, of 30 each. Demographic data, diagnosis, duration of mechanical ventilation (MV), endotracheal tube size, need of inotropes, vasopressors, and sedation were all recorded. The primary outcome of the study was extubation failure within 48 h. The secondary outcomes studied were mortality, need of respiratory support, duration of oxygen requirement, and length of PICU (LOPICU) stay after extubation.
Results: Age, gender, indication of intubation, duration of MV, and number of SBT attempts were similar in both the groups. There was no statistically significant difference in extubation failure within 48 h between the two groups. Four patients were reintubated in both the groups and two patients died in T piece group and one patient in CPAP group. Postextubation respiratory support, duration of oxygen therapy, LOPICU stay, and mortality were not significant different between the two groups.
Conclusion: There was no significant difference in extubation outcomes when CPAP and T piece were used as methods of SBT. |
topic |
continuous positive airway pressure pediatric intensive care unit spontaneous breathing trial t piece |
url |
http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=3;spage=123;epage=127;aulast=Bairwa |
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