To evaluate the effects of spontaneous breathing trials (SBT) between T-piece and low-level pressure-assisted ventilation (PSV) on clinical outcomes after successful weaning in mechanically ventilated patients.

This retrospective cohort study was performed for 253 critically ill patients with a mechanical ventilation duration of 24 hours to 2 weeks admitted to the Department of Surgical Intensive Care of the First Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2020. All patients successfully passed SBT and removed the endotracheal intubation, and were divided into PSV group and T-piece group according to the SBT method before extubation. The differences in clinical outcomes such as the incidence of respiratory failure, time of occurrence of respiratory failure, causes of respiratory failure, reintubation rate, time to extubation, duration of ICU stay after extubation, duration of mechanical ventilation, length of stay in ICU, time after admission to extubation, time in hospital, and all-cause mortality rate in hospital were compared between the two groups.

There were no significant differences in the incidence of respiratory failure, time to occurrence of respiratory failure, reintubation rate, inpatient mortality, and length of hospitalization between the two groups (P＞0.05). Compared with the T-piece group, the time from initiation of SBT to removal of the endotracheal tube was significantly shortened in the PSV group, and the duration of mechanical ventilation [2.9 (1.7, 4.8 d) d vs 3.9 (1.8, 6.3) d] and ICU length of stay were shorter [6.2 (3.9, 10.8) d vs 8.8 (4.5, 12.5) d] (P＜0.05).

The low PEEP PSV method used by SBT for mechanical ventilation weaning is more conducive to acceleration the weaning process, reduces mechanical ventilation time, and shortens ICU stay.