{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T20:45:18Z","timestamp":1775508318183,"version":"3.50.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2009,4,14]],"date-time":"2009-04-14T00:00:00Z","timestamp":1239667200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2009,4,14]],"date-time":"2009-04-14T00:00:00Z","timestamp":1239667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>To determine whether subjecting patients to 100 ml of additional dead space after a 120-minute weaning trial could predict readiness for extubation.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>This was a prospective, non-randomised pilot study in an intensive care unit at a university hospital with 14 beds. It included all non-tracheostomised patients with improvement of the underlying cause of acute respiratory failure, and those with no need for vasoactive or sedative drugs were eligible. Patients fulfilling the Consensus Conference on Weaning extubation criteria after 120 minutes spontaneous breathing (n = 152) were included. To the endotracheal tube, 100 cc dead space was added for 30 minutes. Patients tolerating the test were extubated; those not tolerating it received six hours of supplementary ventilation before extubation. The measurements taken and main results were: arterial pressure, heart rate, respiratory rate, oxygen saturation, end-tidal carbon dioxide and signs of respiratory insufficiency were recorded every five minutes; and arterial blood gases were measured at the beginning and end of the test. Extubation failure was defined as the need for mechanical and non-invasive ventilation within 48 hours of extubation.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Twenty-two patients (14.5%) experienced extubation failure. Only intercostal retraction was independently associated with extubation failure. The sensitivity (40.9%) and specificity (97.7%) yield a probability of extubation failure of 75.1% for patients not tolerating the test versus 9.3% for those tolerating it.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>Observing intercostal retraction after adding dead space may help detect susceptibility to extubation failure. The ideal amount of dead space remains to be determined.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Trial registration<\/jats:title>\n                        <jats:p>Current Controlled Trials ISRCTN76206152.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc7783","type":"journal-article","created":{"date-parts":[[2009,4,14]],"date-time":"2009-04-14T18:13:35Z","timestamp":1239732815000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A pilot study of a new test to predict extubation failure"],"prefix":"10.1186","volume":"13","author":[{"given":"Jos\u00e9 F","family":"Solsona","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"D\u00edaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"V\u00e1zquez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Pilar Gracia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Zapatero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Marrugat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2009,4,14]]},"reference":[{"key":"7216_CR1","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1001\/jama.287.3.345","volume":"287","author":"A Esteban","year":"2002","unstructured":"Esteban A, Anzueto A, Frutos F, Al\u00eda I, Brochard L, Stewart TE, Benito S, Epstein SK, Apeztegu\u00eda C, Nightingale P, Arroliga AC, Tobin MJ, Mechanical Ventilation International Study Group: Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study.\n                           JAMA 2002, 287: 345-355. 10.1001\/jama.287.3.345","journal-title":"JAMA"},{"key":"7216_CR2","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1056\/NEJM199105233242101","volume":"324","author":"KL Yang","year":"1991","unstructured":"Yang KL, Tobin MJ: A prospective study of indexes and outcome of trials of mechanical ventilation.\n                           N Engl J Med 1991, 324: 1445-1450.","journal-title":"N Engl J Med"},{"key":"7216_CR3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1164\/arrd.1987.135.4.907","volume":"135","author":"CSH Sassoon","year":"1987","unstructured":"Sassoon CSH, Te TT, Mahutte CK, Light RW: Airway occlusion pressure: an important indicator for successful weaning in patients with chronic obstructive pulmonary disease.\n                           Am Rev Respir Dis 1987, 135: 107-113.","journal-title":"Am Rev Respir Dis"},{"key":"7216_CR4","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1097\/00003246-199203000-00013","volume":"20","author":"G Conti","year":"1992","unstructured":"Conti G, De Blasi R, Pelaia P, Benito S, Rocco M, Antonelli M, Bufi M, Mattia C, Gasparetto A: Early prediction of successful weaning during pressure support ventilation in chronic obstructive pulmonary disease patients.\n                           Crit Care Med 1992, 20: 366-371. 10.1097\/00003246-199203000-00013","journal-title":"Crit Care Med"},{"key":"7216_CR5","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1007\/s001340051015","volume":"25","author":"AA Zeggwagh","year":"1999","unstructured":"Zeggwagh AA, Abouqal R, Madani N, Zekraoui A, Kerkeb O: Weaning from mechanical ventilation: a model for extubation.\n                           Intensive Care Med 1999, 25: 1077-1083. 10.1007\/s001340051015","journal-title":"Intensive Care Med"},{"key":"7216_CR6","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1164\/ajrccm\/148.4_Pt_1.860","volume":"148","author":"CSH Sassoon","year":"1993","unstructured":"Sassoon CSH, Mahutte CK: Airway occlusion pressure and breathing pattern as predictors of weaning outcome.\n                           Am Rev Respir Dis 1993, 148: 860-866.","journal-title":"Am Rev Respir Dis"},{"key":"7216_CR7","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1164\/ajrccm.152.2.7633705","volume":"152","author":"SK Epstein","year":"1995","unstructured":"Epstein SK: Etiology of extubation failure and the predictive value of the rapid shallow breathing index.\n                           Am J Respir Crit Care Med 1995, 152: 545-549.","journal-title":"Am J Respir Crit Care Med"},{"key":"7216_CR8","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1378\/chest.106.4.1188","volume":"106","author":"A Esteban","year":"1994","unstructured":"Esteban A, Al\u00eda I, Iba\u00f1ez J, Benito S, Tobin MJ: Models of mechanical ventilation and weaning. 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