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ORIGINAL ARTICLE
Year : 2020  |  Volume : 33  |  Issue : 2  |  Page : 74-80

T-tube ventilation should be rationalized in pediatric intensive care unit: a comparative study between T-tube and pressure support ventilation during spontaneous breathing trial


1 Department of Pediatrics, Zagazig University, Zagazig, Egypt
2 Department of Anesthesia, Zagazig University, Zagazig, Egypt
3 Department of Chest Diseases, Zagazig University, Zagazig, Egypt

Correspondence Address:
Dalia A Abdelrahman
Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, 11865
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AJOP.AJOP_21_20

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Background Shifting from mechanical ventilation to spontaneous breathing during weaning phase is very critically challenging, and its success depends on many factors including the adopted weaning strategy in each center. Few studies have compared the used weaning procedures in pediatric age groups and their effect on the vital signs as stress predictors during spontaneous breathing trial (SBT). Aim The aim was to compare between t-piece weaning tool and pressure support ventilation (PSV) during SBT in mechanically ventilated pediatric patients to assess patients’ suffering. Patients and methods This prospective cohort study was carried out in the pediatric chest and anesthesia ICUs, Zagazig University Hospitals, Egypt, over a 6-month period (from May to October 2018). A total of 104 ventilated patients aged from 2 months to 18 years were enrolled in this study. All patients were subjected to full clinical assessment, as well as comparative methods between PSV and T-tube (TT) ventilation during weaning process. Results It was found that cardiac arrhythmias accounted for 71.2% of the patients weaned on TT in the form of sinus tachycardia compared with 9.6% of the patients on PSV, with significant difference between the two groups (P<0.001). Moreover, there was a significance increase in the mean arterial blood pressure among patients on TT during weaning process, with increase in the work of breathing (P<0.001). PSV mode had significantly lower PCO2 than TT during weaning (P<0.001). The failure rate was higher when using TT during SBT in comparison with PSV, with more exposure to another weaning trials. Conclusion The authors concluded that PSV has less stressful effects on patients during SBT process. TT weaning procedure has higher failure rate than PSV.


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