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Table 3 Type of assessment and criteria for performing a spontaneous breathing test

From: Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Clinical assessment Improvement of acute process (ARDS and associated conditions) leading to intubation and mechanical ventilation
  Patient is alert and cooperative
  Chest pain is controlled
  Adequate cough (moderate to high strength)
  Absence of excessive tracheobronchial secretion
  No signs of respiratory distress:
   Nostril flaring
   Use of accessory muscles of respiration (suprasternal and/or intercostal retraction)
   Paradoxical movements of the chest/abdomen
Objective measurements Respiratory stability: oxygenation
   PEEP ≤10 cmH2O
   Support pressure ≤10 cmH2O
   PaO2/FiO2 ≥250 (consider weaning if ≥150)
   SpO2 > 90% under FiO2 ≤40%
  Respiratory stability: function
   Respiratory rate ≤35 breaths/min 
   Minute volume  < 10 L/min
   Respiratory rate/tidal volume (L)  < 105 breath/min/L
   No significant respiratory acidosis (pH ≥7.25) 
  Cardiovascular stability
   Heart rate <140 bpm
   Systolic blood pressure  > 90 and <160 mmHg
   Without vasoconstrictor/inotropic drugs (or low doses) 
  Neurological stability
   Patient alert and cooperative - SAS 4 (acceptable: slightly drowsy patient (SAS 3) slightly agitated (SAS 5))