{Reference Type}: Systematic Review
{Title}: Pressure Support Ventilation Versus T-piece as Spontaneous Breathing Trials for Extubation of Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
{Author}: Fonseca LM;da Câmara PM;Lettieri IMP;Dagostin CS;de Abreu Vianna AO;
{Journal}: Lung
{Volume}: 202
{Issue}: 2
{Year}: 2024 Apr 12
{Factor}: 3.777
{DOI}: 10.1007/s00408-024-00678-2
{Abstract}: <B>BACKGROUND: </B>Weaning patients with COPD from mechanical ventilation (MV) presents a challenge, as literature on this topic is limited. This study compares PSV and T-piece during spontaneous breathing trials (SBT) in this specific population.<BR><B>METHODS: </B>A search of PubMed, EMBASE, and Cochrane in September 2023 yielded four randomized controlled trials (RCTs) encompassing 560 patients. Among these, 287 (51%) used T-piece during SBTs.<BR><B>RESULTS: </B>The PSV group demonstrated a significant improvement in the successful extubation rate compared to the T-piece (risk ratio [RR] 1.14; 95% confidence interval [CI] 1.03-1.26; p = 0.02). Otherwise, there was no statistically significant difference in the reintubation (RR 1.07; 95% CI 0.79-1.45; p = 0.67) or the ICU mortality rates (RR 0.99; 95% CI 0.63-1.55; p = 0.95).<BR><B>CONCLUSIONS: </B>Although PSV in SBTs exhibits superior extubation success, consistent weaning protocols warrant further exploration through additional studies.