Identifying Predictors of Extubation on the day of Passing an SBT in Critically ill Adults

Many patients who pass a spontaneous awakening trial (SAT) and spontaneous breathing trial (SBT) do not undergo extubation that day. Therefore, the study aimed to identify predictors of extubation on the day of passing an SBT and to develop prediction models for extubation among mechanically ventilated patients. Independent predictors of extubation included higher Richmond Agitation Sedation Scale (RASS), receipt of sedation on the day prior, absence of diagnosis of sepsis or septic shock, absence of neurological illness, indication for intubation of altered mental status, seizure, or agitation, and absence of hemodynamic instability or cardiac arrest. Patients on mechanical ventilation were more likely to be extubated on the day they passed an SBT if they had higher RASS scores, received sedation the day prior, or did not have a diagnosis of sepsis, neurological illness, or hemodynamic instability. Future research should attempt to identify and address modifiable risk factors for failure to extubate after passing an SBT.