Table 1 Exclusion criteria
1. Brain death or expected brain death | |
2. Patients who have evidence of myocardial ischemia in the 24-h period before enrollment, except if current trend in troponin is downward AND it has been ≥ 24 h since last troponin peak or the patient has undergone a revascularization procedure and attending physician has no concerns regarding ongoing ischemia | |
3. Patients who have received continuous invasive mechanical ventilation for ≥ 2 weeks | |
4. Patients who have a tracheostomy in situ at the time of screening | |
5. Patients who are receiving sedative infusions for seizures or alcohol withdrawal | |
6. Patients who require escalating doses of sedative agents | |
7. Patients who are receiving neuromuscular blockers or who have known quadriplegia, paraplegia, or four-limb weakness or paralysis preventing active mobilization (e.g. active range of motion, exercises in bed, sitting at edge of bed, transferring from bed to chair, standing, marching in place, ambulating) | |
8. Patients who are moribund (e.g. at imminent risk for death) or who have limitations of treatment (e.g. withdrawal of support, do not reintubate order, however, do not resuscitate orders will be permitted) | |
9. Patients who have profound neurologic deficits (e.g. after cardiac or respiratory arrest, large intracranial stroke or bleed) or GCS ≤ 6 | |
10. Patients who are using modes that automate SBT conduct | |
11. Patients who are current enrolled in a confounding study that includes a weaning protocol, or | |
12. Patients who were previously enrolled in this trial | |
13. Patients who have already undergone an SBT or are on T-piece, or CPAP alone (without PS), or PS ≤ 8 cm H2O regardless of PEEP, or other “SBT equivalent” settings immediately before randomization | |
14. Patients who have already undergone extubation (planned, unplanned [e.g. self, accidental]) during the same ICU admission |