{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:50:55Z","timestamp":1793764255052,"version":"4.6.1"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":61,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Conventional parameters to determine the success of spontaneous breathing trials (SBTs) may fail to detect impending respiratory distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess whether SBT-induced changes in respiratory system compliance, inspiratory effort, and respiratory drive measured as occlusion pressure during the first 100 milliseconds (P0.1), all assessed noninvasively through airway occlusions, are associated with extubation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter study on patients at high risk of extubation failure who successfully passed a 30-minute SBT on the basis of conventional parameters. The SBT was reproduced using a specific ventilator immediately before extubation to continuously monitor respiratory system compliance, inspiratory effort, and P0.1. Extubation failure was defined as reintubation within 72 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Forty-six (19%) of 238 extubated patients required reintubation. No differences in Vt or respiratory rate were observed between successfully extubated and reintubated patients at any time. In the success group, inspiratory effort and normalized compliance (i.e., scaled to predicted body weight) remained unchanged throughout the SBT. In the failure group, normalized compliance declined (1.0 [0.8\u20131.2] to 0.7 [0.6\u20130.9] ml\/cm H2O\/kg; P\u2009&amp;lt;\u20090.001), whereas inspiratory effort increased (12 [10\u201315] to 18 [15\u201320] cm H2O; P\u2009&amp;lt;\u20090.001) during the SBT. P0.1 increased in both groups but more markedly in reintubated patients (2 [1.5\u20132.4] to 3.2 [2.9\u20133.5] cm H2O; P\u2009&amp;lt;\u20090.001). SBT-induced normalized compliance reduction less than or equal to \u22120.2 ml\/cm H2O\/kg (less than or equal to \u22120.1; less than or equal to \u22120.2) and inspiratory effort increase &amp;gt;2 cm H2O (&amp;gt;1, &amp;gt;3) were the most accurate predictors of extubation failure (area under the curve, 0.90 [0.84\u20130.93]; sensitivity, 80%; specificity, 83%; area under the curve, 0.94 [0.90\u20130.97]; sensitivity, 89%; specificity, 93%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In high-risk patients, SBT-induced declines in respiratory system compliance and increases in inspiratory effort are associated with extubation failure.<\/jats:p>\n                    <jats:p>Clinical trial registered with www.clinicaltrials.gov (NCT05295186).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202503-0544oc","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:19:06Z","timestamp":1760134746000},"page":"2340-2351","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":15,"title":["Assessment of Respiratory Mechanics and Inspiratory Effort During Spontaneous Breathing Trials to Predict Extubation Failure in High-Risk Patients"],"prefix":"10.1093","volume":"211","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-3016","authenticated-orcid":false,"given":"Francesco","family":"Murgolo","sequence":"first","affiliation":[{"name":"Department of Precision-Regenerative Medicine and Jonic Area, Section of Anesthesiology, University of Bari \u201cAldo Moro,\u201d Bari, Italy"},{"name":"Department of Anesthesia and Critical Care, Policlinico di Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savino","family":"Spadaro","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Section of Anesthesiology and Intensive Care Medicine, University of Ferrara, Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4557-6308","authenticated-orcid":false,"given":"Domenico L.","family":"Grieco","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy"},{"name":"Department of Emergency, ASST Spedali Civili University Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Pisani","sequence":"additional","affiliation":[{"name":"Department of Precision-Regenerative Medicine and Jonic Area, Section of Anesthesiology, University of Bari \u201cAldo Moro,\u201d Bari, Italy"},{"name":"Department of Anesthesia and Critical Care, Policlinico di Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Spinazzola","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Di Mussi","sequence":"additional","affiliation":[{"name":"Department of Precision-Regenerative Medicine and Jonic Area, Section of Anesthesiology, University of Bari \u201cAldo Moro,\u201d Bari, Italy"},{"name":"Department of Anesthesia and Critical Care, Policlinico di Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Michi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Bartolomeo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Policlinico di Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Fanelli","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, Turin, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Terragni","sequence":"additional","affiliation":[{"name":"Division of Anesthesia and General Intensive Care, Department of Medical, Surgical and Experimental Sciences, University Hospital of Sassari, University of Sassari, Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. Marco","family":"Ranieri","sequence":"additional","affiliation":[{"name":"Department of Precision-Regenerative Medicine and Jonic Area, Section of Anesthesiology, University of Bari \u201cAldo Moro,\u201d Bari, Italy"},{"name":"Department of Anesthesia and Critical Care, Policlinico di Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0287-0232","authenticated-orcid":false,"given":"Salvatore","family":"Grasso","sequence":"additional","affiliation":[{"name":"Department of Precision-Regenerative Medicine and Jonic Area, Section of Anesthesiology, University of Bari \u201cAldo Moro,\u201d Bari, Italy"},{"name":"Department of Anesthesia and Critical Care, Policlinico di Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"2026013020452788700_bib1","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1164\/rccm.201208-1523CI","article-title":"The decision to extubate in the intensive care unit","volume":"187","author":"Thille","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib2","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1177\/08850666221095436","article-title":"To wean or not to wean: a practical patient focused guide to ventilator weaning","volume":"37","author":"Akella","year":"2022","journal-title":"J Intensive Care Med"},{"key":"2026013020452788700_bib3","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1183\/09031936.00010206","article-title":"Weaning from mechanical ventilation","volume":"29","author":"Boles","year":"2007","journal-title":"Eur Respir J"},{"key":"2026013020452788700_bib4","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1164\/ajrccm.156.2.9610109","article-title":"Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation","volume":"156","author":"Esteban","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib5","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s00134-010-1870-0","article-title":"Physiological comparison of three spontaneous breathing trials in difficult-to-wean patients","volume":"36","author":"Cabello","year":"2010","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib6","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/s13054-016-1533-9","article-title":"Cardiac dysfunction induced by weaning from mechanical ventilation: incidence, risk factors, and effects of fluid removal","volume":"20","author":"Liu","year":"2016","journal-title":"Crit Care"},{"key":"2026013020452788700_bib7","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1164\/rccm.201201-0050ED","article-title":"Extubation and the myth of \u2018minimal ventilator settings.\u2019","volume":"185","author":"Tobin","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib8","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/s00134-024-07330-w","article-title":"Effect of aggressive vs conservative screening and confirmatory test on time to extubation among patients at low or intermediate risk: a randomized clinical trial","volume":"50","author":"Hern\u00e1ndez Mart\u00ednez","year":"2024","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib9","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1164\/rccm.201610-2076ST","article-title":"Official executive summary of an American Thoracic Society\/American College of Chest Physicians clinical practice guideline: liberation from mechanical ventilation in critically ill adults","volume":"195","author":"Schmidt","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib10","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1164\/ajrccm.155.3.9117025","article-title":"Pathophysiologic basis of acute respiratory distress in patients who fail a trial of weaning from mechanical ventilation","volume":"155","author":"Jubran","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib11","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1164\/rccm.200503-356OC","article-title":"Weaning prediction: esophageal pressure monitoring complements readiness testing","volume":"171","author":"Jubran","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib12","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s13054-020-2777-y","article-title":"Monitoring patient respiratory effort during mechanical ventilation: lung and diaphragm-protective ventilation","volume":"24","author":"Bertoni","year":"2020","journal-title":"Crit Care"},{"key":"2026013020452788700_bib13","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00134-018-5311-9","article-title":"Plateau and driving pressure in the presence of spontaneous breathing","volume":"45","author":"Bellani","year":"2019","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib14","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1164\/ajrccm.156.4.96-02031","article-title":"End-inspiratory airway occlusion: a method to assess the pressure developed by inspiratory muscles in patients with acute lung injury undergoing pressure support","volume":"156","author":"Foti","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib15","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s13054-019-2617-0","article-title":"A novel non-invasive method to detect excessively high respiratory effort and dynamic transpulmonary driving pressure during mechanical ventilation","volume":"23","author":"Bertoni","year":"2019","journal-title":"Crit Care"},{"key":"2026013020452788700_bib16","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/0034-5687(75)90059-6","article-title":"Occlusion pressure as a measure of respiratory center output in conscious man","volume":"23","author":"Whitelaw","year":"1975","journal-title":"Respir Physiol"},{"key":"2026013020452788700_bib17","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1007\/s00134-018-5045-8","article-title":"The airway occlusion pressure (P0.1) to monitor respiratory drive during mechanical ventilation: increasing awareness of a not-so-new problem","volume":"44","author":"Telias","year":"2018","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib18","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1001\/jama.2016.14194","article-title":"Effect of postextubation high-flow nasal cannula vs noninvasive ventilation on reintubation and postextubation respiratory failure in high-risk patients a randomized clinical trial","volume":"316","author":"Hern\u00e1ndez","year":"2016","journal-title":"JAMA"},{"key":"2026013020452788700_bib19","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1007\/s00134-017-4911-0","article-title":"Reconnection to mechanical ventilation for 1 h after a successful spontaneous breathing trial reduces reintubation in critically ill patients: a multicenter randomized controlled trial","volume":"43","author":"Fernandez","year":"2017","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib20","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s00134-007-0681-4","article-title":"A method for monitoring and improving patient: ventilator interaction","volume":"33","author":"Younes","year":"2007","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib21","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1164\/ajrccm\/145.1.114","article-title":"Proportional assist ventilation, a new approach to ventilatory support: theory","volume":"145","author":"Younes","year":"1992","journal-title":"Am Rev Respir Dis"},{"key":"2026013020452788700_bib22","doi-asserted-by":"crossref","first-page":"382","DOI":"10.21037\/atm.2018.08.32","article-title":"Respiratory mechanics in patients with acute respiratory distress syndrome","volume":"6","author":"Russotto","year":"2018","journal-title":"Ann Transl Med"},{"key":"2026013020452788700_bib23","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/00132586-200102000-00017","article-title":"Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome","volume":"45","year":"2001","journal-title":"Surv Anesthesiol"},{"key":"2026013020452788700_bib24","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1056\/NEJM199105233242101","article-title":"A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation","volume":"324","author":"Yang","year":"1991","journal-title":"N Engl J Med"},{"key":"2026013020452788700_bib25","doi-asserted-by":"crossref","first-page":"1602426","DOI":"10.1183\/13993003.02426-2016","article-title":"Official ERS\/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure","volume":"50","author":"Rochwerg","year":"2017","journal-title":"Eur Respir J"},{"key":"2026013020452788700_bib26","doi-asserted-by":"crossref","first-page":"4","DOI":"10.22237\/jmasm\/1241136180","article-title":"Aligned rank tests for interactions in split-plot designs: distributional assumptions and stochastic heterogeneity","volume":"8","author":"Beasley","year":"2009","journal-title":"J Mod Appl Stat Methods"},{"key":"2026013020452788700_bib27","doi-asserted-by":"crossref","first-page":"78","DOI":"10.22237\/jmasm\/1462075500","article-title":"New nonparametric rank tests for interactions in factorial designs with repeated measures","volume":"15","author":"Feys","year":"2016","journal-title":"J Mod App Stat Meth"},{"key":"2026013020452788700_bib28","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/01621459.1987.10478410","article-title":"Better bootstrap confidence intervals","volume":"82","author":"Efron","year":"1987","journal-title":"J Am Stat Assoc"},{"key":"2026013020452788700_bib29","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00134-009-1735-6","article-title":"Evolution of pattern of breathing during a spontaneous breathing trial predicts successful extubation","volume":"36","author":"Segal","year":"2010","journal-title":"Intensive Care Med"},{"issue":"6 Suppl","key":"2026013020452788700_bib30","doi-asserted-by":"crossref","first-page":"375S","DOI":"10.1378\/chest.120.6_suppl.375S","article-title":"Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine","volume":"120","author":"MacIntyre","year":"2001","journal-title":"Chest"},{"key":"2026013020452788700_bib31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1164\/ajrccm.152.1.7599811","article-title":"Variability of patient-ventilator interaction with pressure support ventilation in patients with chronic obstructive pulmonary disease","volume":"152","author":"Jubran","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib32","first-page":"1111","article-title":"The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation","volume":"134","author":"Tobin","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"2026013020452788700_bib33","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1164\/ajrccm.164.5.2012122","article-title":"Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease","volume":"164","author":"O\u2019Donnell","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib34","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1164\/rccm.2206020","article-title":"Disorders of the respiratory muscles","volume":"168","author":"Laghi","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib35","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s00134-005-2678-1","article-title":"Mechanisms of hypoxemia","volume":"31","author":"Rodr\u00edguez-Roisin","year":"2005","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib36","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00134-015-4200-8","article-title":"The \u2018baby lung\u2019 became an adult","volume":"42","author":"Gattinoni","year":"2016","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib37","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00000542-198808000-00004","article-title":"Acute left ventricular dysfunction during unsuccessful weaning from mechanical ventilation","volume":"69","author":"Lemaire","year":"1988","journal-title":"Anesthesiology"},{"key":"2026013020452788700_bib38","first-page":"6","article-title":"Cardiopulmonary interactions in patients with heart failure","volume":"13","author":"Monnet","year":"2007","journal-title":"Curr Opin Crit Care"},{"key":"2026013020452788700_bib39","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/ALN.0000000000000694","article-title":"Assisted ventilation in patients with acute respiratory distress syndrome: lung-distending pressure and patient-ventilator interaction","volume":"123","author":"Doorduin","year":"2015","journal-title":"Anesthesiology"},{"key":"2026013020452788700_bib40","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1164\/rccm.201605-0992OC","article-title":"The diaphragm acts as a brake during expiration to prevent lung collapse","volume":"195","author":"Pellegrini","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib41","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s00134-012-2700-3","article-title":"Diaphragm electromyographic activity as a predictor of weaning failure","volume":"38","author":"Dres","year":"2012","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib42","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/ALN.0000000000002256","article-title":"Respiratory muscle effort during expiration in","volume":"129","author":"Doorduin","year":"2018","journal-title":"Anesthesiology"},{"key":"2026013020452788700_bib43","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1164\/rccm.201902-0454LE","article-title":"Assessment of airway driving pressure and respiratory system mechanics during neurally adjusted ventilatory assist","volume":"200","author":"Grasselli","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib44","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/ALN.0000000000004467","article-title":"Performance of noninvasive airway occlusion maneuvers to assess lung stress and diaphragm effort in mechanically ventilated critically ill patients","volume":"138","author":"De Vries","year":"2023","journal-title":"Anesthesiology"},{"key":"2026013020452788700_bib45","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1164\/rccm.202108-1857OC","article-title":"Prevalence, intensity, and clinical impact of dyspnea in critically ill patients receiving invasive ventilation","volume":"205","author":"Demoule","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2026013020452788700_bib46","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13613-025-01455-x","article-title":"Automatic continuous P0.1 measurements during weaning from mechanical ventilation: a clinical study","volume":"15","author":"Delamaire","year":"2025","journal-title":"Ann Intensive Care"},{"key":"2026013020452788700_bib47","doi-asserted-by":"crossref","first-page":"2101574","DOI":"10.1183\/13993003.01574-2021","article-title":"ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure","volume":"59","author":"Oczkowski","year":"2022","journal-title":"Eur Respir J"},{"key":"2026013020452788700_bib48","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1001\/jama.2019.14901","article-title":"Effect of postextubation high-flow nasal oxygen with noninvasive ventilation vs high-flow nasal oxygen alone on reintubation among patients at high risk of extubation failure: a randomized clinical trial","volume":"322","author":"Thille","year":"2019","journal-title":"JAMA"},{"key":"2026013020452788700_bib49","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s00134-022-06919-3","article-title":"Effect of postextubation noninvasive ventilation with active humidification vs high-flow nasal cannula on reintubation in patients at very high risk for extubation failure: a randomized trial","volume":"48","author":"Hern\u00e1ndez","year":"2022","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib50","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s00134-024-07758-0","article-title":"Best clinical model predicting extubation failure: a diagnostic accuracy post hoc analysis","volume":"51","author":"Rodr\u00edguez Villamizar","year":"2025","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib51","doi-asserted-by":"crossref","first-page":"2452","DOI":"10.1056\/NEJMoa032736","article-title":"Noninvasive positive-pressure ventilation for respiratory failure after extubation","volume":"350","author":"Esteban","year":"2004","journal-title":"N Engl J Med"},{"key":"2026013020452788700_bib52","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1007\/s00134-023-07048-1","article-title":"Personalized noninvasive respiratory support for acute hypoxemic respiratory failure","volume":"49","author":"Grieco","year":"2023","journal-title":"Intensive Care Med"},{"key":"2026013020452788700_bib53","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s13054-025-05366-y","article-title":"Physiological comparison of noninvasive ventilation and high-flow nasal oxygen on inspiratory efforts and tidal volumes after extubation: a randomized crossover trial","volume":"29","author":"Arrive","year":"2025","journal-title":"Crit Care"},{"key":"2026013020452788700_bib54","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1164\/ajrccm\/143.3.469","article-title":"Pressure-time product during continuous positive airway pressure, pressure support ventilation, and T-piece during weaning from mechanical ventilation","volume":"143","author":"Sassoon","year":"1991","journal-title":"Am Rev Respir Dis"},{"key":"2026013020452788700_bib55","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1186\/s13054-024-05003-0","article-title":"Operator independent continuous ultrasound monitoring of diaphragm excursion predicts successful weaning from mechanical ventilation: a prospective observational study","volume":"28","author":"Demoule","year":"2024","journal-title":"Crit Care"},{"key":"2026013020452788700_bib56","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13054-024-05243-0","article-title":"Ventilation distribution during spontaneous breathing trials predicts liberation from mechanical ventilation: the VISION study","volume":"29","author":"Phoophiboon","year":"2025","journal-title":"Crit Care"},{"key":"2026013020452788700_bib57","doi-asserted-by":"crossref","first-page":"R143","DOI":"10.1186\/cc11451","article-title":"Neuroventilatory efficiency and extubation readiness in critically ill patients","volume":"16","author":"Liu","year":"2012","journal-title":"Crit Care"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/211\/12\/2340\/66621586\/ajrccm_211_12_2340.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/211\/12\/2340\/66621586\/ajrccm_211_12_2340.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T01:45:40Z","timestamp":1769823940000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/211\/12\/2340\/8444246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":57,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,1]]},"published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.202503-0544oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}