Abstract

The aims of this study were to determine the effectiveness of the weaning parameters, the reasons for weaning failures, the frequency of buildup complications in patients who were extubated following 2-hour Tpiece trial. We included 56 patients who were mechanically ventilated at least for 24 hours in three different ICUs and extubated following 2-hour T-piece trial. The frequency of reintubation was 32.1%, and the average reintubation time was 16,50±14,46 hours. The persistence of disease reduced the success of weaning trials. Measured airway pressures during mechanically ventilation before T-piece was significantly lower in the successful group (peak pressure 20,21±4,07 cmH2O and plato pressure 9,50±2,09 cmH2O) rather than the unsuccessful group (peak pressure 23,89±5,06 cmH2O, plato pressure 11,67±2,63 cmH2O). Tpiece and post-extubation 1-hour PaCO2 values of unsuccessful group (42,80±12,86 mm Hg and 47,42±14,4 mmHg respectively) was higher than the successful group (37,24±6,57 mmHg and 38,44±5,85 mm Hg respectively). Frequency/tidal volume ratio (f/VT)<105 increased the success of weaning trials. Other weaning parameters were not effective in predicting the weaning results. Increase in mortality rate for reintubated patients (%38.9) was significant in comparison to that of successfully extubated patients (%5.3). The complication rate directly related to weaning trials was %1.7, and there was no related mortality. The most frequent reason for reintubation was hypoxemic respiratory failure (%39) followed by upper airway obstruction (17%). In conclusion, persistence of disease increases the weaning failure, and reentubation is frequent during the weaning process. The causes of upper-airway obstruction have a significant role in weaning failure. Mortality is increased in reentubated patients.The f/VT rate is the most beneficial parameter for estimating weaning result.