🫁 Spontaneous Breathing Trial Screening (SBT Readiness)
Spontaneous breathing trial (SBT) readiness and interpretation for liberation from mechanical ventilation.
Spontaneous Breathing Trial Screening (SBT Readiness)
Cause of respiratory failure improved/controlled
Adequate oxygenation (PaO₂/FiO₂ ≥ 150, FiO₂ ≤ 0.5, PEEP ≤ 5–8, SpO₂ ≥ 90%)
Hemodynamically stable (no/low-dose vasopressors, no active myocardial ischemia)
pH ≥ 7.25
Can trigger spontaneous breaths, arousable
When to use
Use to check readiness criteria before an SBT and to interpret pass/fail to guide extubation.
How it works
Assess readiness (resolving cause, adequate oxygenation on low support, hemodynamic stability, intact airway protection); perform SBT 30–120 min on minimal support or T-piece; pass → consider extubation; fail → resume support and address the cause.
Key points
- Daily readiness screening plus an SBT shortens ventilation duration compared with gradual weaning (original synthesis · not guideline verbatim).
- Pair the SBT with a spontaneous awakening trial (sedation interruption) for the greatest benefit.
- A passed SBT does not guarantee extubation success — also assess airway patency (cuff leak) and secretion burden.
References
- Girard TD, et al. ABC trial (awakening + breathing). Lancet 2008.
- ATS/ACCP liberation guidelines. Am J Respir Crit Care Med 2017.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.