Related Experiment Video
Updated: Jun 29, 2026
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Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns
Published on: September 16, 2019
Multicenter implementation of a consensus-developed, evidence-based, spontaneous breathing trial protocol.
T Elizabeth Robertson1, Henry J Mann, Robert Hyzy
1Department of Surgery, Washington University in St. Louis, St. Louis, MO, USA. robertsont@wudosis.wustl.edu
Critical Care Medicine
|October 2, 2008
Summary
A peer network effectively implemented a spontaneous breathing trial protocol in intensive care units. However, this best practice alone was insufficient for consistent, timely ventilator liberation in critically ill patients.
Area of Science:
- Critical Care Medicine
- Pulmonary Medicine
- Health Services Research
Background:
- Evidence-based practice recommendations are often difficult to implement and audit effectively in clinical settings.
- Implementing best practice protocols requires structured approaches and robust measurement of patient outcomes.
- Peer networks offer a potential mechanism for improving the adoption and adherence to clinical guidelines.
Purpose of the Study:
- To assess the effectiveness of a peer network in implementing an evidence-based best practice protocol for spontaneous breathing trials (SBTs).
- To measure patient outcomes related to the implementation of the SBT protocol across multiple intensive care units.
- To evaluate the impact of a standardized SBT protocol on ventilator liberation rates.
Main Methods:
- A consensus definition of spontaneous breathing trial (SBT) was established.
- The SBT protocol was implemented across eight academic medical centers, including medical, surgical, and combined intensive care units.
- Patients initiating mechanical ventilation were screened for eligibility and underwent safety and tolerance assessments for SBTs.
Main Results:
- Out of 705 patients, 3,486 safety screens were performed; 59% failed safety screens, and 11% failed a 2-minute tolerance screen.
- A full 30-120 minute spontaneous breathing trial was completed in 34% of patients, with 70% of eligible patients enrolled.
- Only 55% of successful SBTs led to liberation from mechanical ventilation before another SBT was initiated.
Conclusions:
- Peer networks can successfully promote and implement evidence-based best practices in healthcare settings.
- While implementing a best practice like SBT is crucial, it is not sufficient on its own to ensure consistent and timely ventilator liberation.
- Further strategies are needed to optimize the process of weaning patients from mechanical ventilation even after successful SBTs.
