Related Experiment Video
Updated: Feb 25, 2026
Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Spontaneous breathing test in the prediction of extubation failure in the pediatric population
Milena Siciliano Nascimento1, Celso Moura Rebello1, Luciana Assis Pires Andrade Vale1
1Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Insights
The spontaneous breathing test (SBT) did not effectively predict extubation failure in pediatric patients. This study found no significant difference in extubation success rates between groups who did and did not undergo the SBT.
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Respiratory Therapy
Background:
- Extubation failure in pediatric patients can lead to prolonged mechanical ventilation and increased morbidity.
- Predictive tools are essential for optimizing extubation timing and reducing complications.
- The spontaneous breathing test (SBT) is a common method to assess readiness for extubation.
Purpose of the Study:
- To evaluate the predictive value of the spontaneous breathing test (SBT) for extubation failure in a pediatric population.
- To compare extubation outcomes in pediatric patients undergoing mechanical ventilation with and without a preceding SBT.
Main Methods:
- A prospective, observational study conducted in a Pediatric Intensive Care Unit (PICU) from May 2011 to August 2013.
- Inclusion criteria: pediatric inpatients on mechanical ventilation for ≥24 hours, followed by extubation.
- Patients were divided into two groups: Test Group (extubated after SBT) and Control Group (extubated without SBT).
Main Results:
- A total of 95 children were analyzed (71 in Test Group, 24 in Control Group).
- No significant differences were observed in demographic or baseline respiratory parameters between the groups.
- The likelihood of extubation failure was not significantly different between the Control Group and the Test Group (p=0.706).
Conclusions:
- The spontaneous breathing test (SBT) was not found to be a reliable predictor of extubation failure in the pediatric population.
- Further research may be needed to identify more accurate predictors of successful extubation in critically ill children.
Objective:
To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population.
Methods:
A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test.
Results:
A total of 95 children were enrolled in the study, 71 in the Test Group and 24 in the Control Group. A direct comparison was made between the two groups regarding sex, age, mechanical ventilation time, indication to start mechanical ventilation and respiratory parameters before extubation in the Control Group, and before the spontaneous breathing test in the Test Group. There was no difference between the parameters evaluated. According to the analysis of probability of extubation failure between the two groups, the likelihood of extubation failure in the Control Group was 1,412 higher than in the Test Group, nevertheless, this range did not reach significance (p=0.706). This model was considered well-adjusted according to the Hosmer-Lemeshow test (p=0.758).
Conclusion:
The spontaneous breathing test was not able to predict the extubation failure in pediatric population.
Objetivo:
Avaliar se o teste de respiração espontânea pode ser utilizado para predizer falha da extubação na população pediátrica.
MéTodos:
Estudo prospectivo, observacional, no qual foram avaliados todos os pacientes internados no Centro de Terapia Intensiva Pediátrica, no período de maio de 2011 a agosto de 2013, que utilizaram ventilação mecânica por mais de 24 horas e que foram extubados. Os pacientes foram classificados em dois grupos: Grupo Teste, que incluiu os pacientes extubados depois do teste de respiração espontânea; e Grupo Controle, pacientes foram sem teste de respiração espontânea.
Resultados:
Dos 95 pacientes incluídos no estudo, 71 crianças eram do Grupo Teste e 24 eram do Grupo Controle. Os grupos foram comparados em relação a: sexo, idade, tempo de ventilação mecânica, indicação para início da ventilação mecânica e parâmetros ventilatórios pré-extubação, no Grupo Controle, e pré-realização do teste, no Grupo Teste. Não foram observadas diferenças entre os parâmetros analisados. Em relação à análise da probabilidade de falha da extubação entre os dois grupos de estudo, a chance de falha do Grupo Controle foi 1.412 maior do que a das crianças do Grupo Teste, porém este acréscimo não foi significativo (p=0,706). O modelo foi considerado bem ajustado de acordo com o teste de Hosmer-Lemeshow (p=0,758).
ConclusãO:
O teste de respiração espontânea para a população pediátrica não foi capaz de prever a falha da extubação.
Related Concept Videos
01:24Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:25Pulmonary Function Tests
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
01:15Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement: