RECONNECT Trial Summary: Mechanical Ventilation After Successful Spontaneous Breathing Trial

2017 RECONNECT TRIAL Reconnection to mechanical ventilation (MV) for 1h after a successful spontaneous breathing trial (SBT) reduces reintubation in critically ill patients. Parallel, two-arm, prospective randomised controlled trial Objective: To evaluate the reduction in need for reintubation in critically ill patients who pass a SBT by 1-hour rest compared with immediate extubation (control) 470 Inclusion criteria: ICU patients aged > 18 years who received invasive MV for 12 hours were screened daily and followed prospectively (while undergoing serial SBTS) until they successfully completed an SBT patients 1-hr REST by reconnecting to MV (n=227] ON Immediate extubation (n=243] PRIMARY OUTCOME Re-intubation within 48h % OR 0.33; 95% CI 0.16-0.65; P<0.001 SECONDARY OUTCOME Post extubation Resp. failure within 48h % 24 OR 0.35; P<0.001 No difference in length of ICU or hospital stay or mortality Conclusion: 1-hr rest after a successful SBT reduces reintubation and post extubation respiratory failure in critically ill patients. MM Fernandez et al. Intensive Care Med 2017 Nov;43(11):1660-1667 Summary by Dr. Shreyash Bhoyar, MBBS

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