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Updated: Jun 2, 2026
05:05
A Structured Approach to Extubation in Mechanically Ventilated Rats
Published on: July 18, 2025
Successful Implementation of a Nurse-Led Daily Spontaneous Awakening Trial Within a Modified Extubation Protocol: A
Kenichi Nitta1, Hiroshi Imamura1, Hiroshi Kamijo1
1Advanced Emergency and Critical Care Center, Shinshu University Hospital, Matsumoto, JPN.
Cureus
|June 1, 2026
Summary
A modified extubation protocol with nurse-led spontaneous awakening trials (SATs) and enhanced risk assessment did not significantly alter mechanical ventilation duration, re-intubation rates, or post-extubation respiratory failure (PERF) compared to the existing protocol.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Nursing Practice
Background:
- Successful extubation requires systematic assessment of readiness.
- Current guidelines recommend daily spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs).
- Post-extubation failure necessitates standardized risk stratification.
Purpose of the Study:
- To evaluate the feasibility and safety of a modified extubation protocol.
- To compare outcomes between a modified protocol (MP) and an existing protocol (EP).
Main Methods:
- Retrospective before-and-after study at Shinshu University Hospital.
- Compared adult patients receiving mechanical ventilation (MV) for ≥48 hours.
- Used inverse probability of treatment weighting (IPTW) for baseline adjustment.
Main Results:
- No significant differences in MV duration, re-intubation rate, or post-extubation respiratory failure (PERF) between MP and EP groups after IPTW.
- MP group showed significantly higher prophylactic high-flow nasal cannula (HFNC) use.
- Study was underpowered to confirm equivalence.
Conclusions:
- The modified extubation protocol was feasible and safe but did not statistically improve key extubation outcomes.
- A higher rate of prophylactic HFNC use was observed with the modified protocol.
- Findings are hypothesis-generating, suggesting further research is needed.
Keywords:
extubationmechanical ventilationnurse-led daily spontaneous awakening trialspontaneous awakening trialweaning protocolMore Related Videos
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