Table of Contents
ISRN Pediatrics
Volume 2013, Article ID 871376, 6 pages
http://dx.doi.org/10.1155/2013/871376
Clinical Study

Automatic Tube Compensation versus Pressure Support Ventilation and Extubation Outcome in Children: A Randomized Controlled Study

1Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
2Specialized New Children Hospital, Faculty of Medicine, Cairo University, Ali Basha Ebrahim St., P.O. Box 11562, Cairo, Egypt

Received 3 January 2013; Accepted 25 January 2013

Academic Editors: M. Adhikari, G. J. Casimir, V. M. Di Ciommo, and B. Vasarhelyi

Copyright © 2013 Ahmed Saad El-din El-beleidy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Automatic tube compensation (ATC) has been developed to overcome the imposed work of breathing due to artificial airways during spontaneous breathing trials (SBTs). Objectives. This study aimed to assess extubation outcome after an SBT (spontaneous breathing trial) with ATC compared with pressure support ventilation (PSV) and to determine the risk factors for extubation failure. Methods. Patients ready for extubation were randomly assigned to two-hour spontaneous breathing trial with either ATC or pressure support ventilation. Results. In the ATC group ( ), 11 (65%) patients passed the SBT with subsequent extubation failure (9%). While in PSV group ( ), 10 (53%) patients passed the SBT with subsequent extubation failure (10%). This represented a positive predictive value for ATC of 91% and PSV of 90% ( ). Five (83%) of the patients who failed the SBT in ATC group were reintubated. This represented a higher negative predictive value for ATC of 83% than for PSV which was 56%. None of the assessed risk factors were independently associated with extubation failure including failed trial. Conclusion. ATC was equivalent to PSV in predicting patients with successful extubation. A trial failure in ATC group is associated with but does not definitely predict extubation failure.