呼吸試験とは何ですか？
Breathing Trials 呼吸試験 - Two brief (15 min) breathing trials to compare PSV (pressure support = 8 cmH2O) with NAVA (Gain = 5 cmH2O/μV, inspiratory trigger = 0. [1] This institution-specific guideline emphasized protocolized sedation with increased as needed boluses, and nonbenzodiazepine infusions, daily sedation interruption, and pairing of spontaneous awakening (SAT) and breathing trials (SBT). [2] Non-pharmacological interventions such as complete adherence to the ABCDEF (Assess, prevent, and manage pain; Both spontaneous awakening and breathing trials: Choice of analgesia and sedation; Delirium assess, prevent, and manage; Early mobility and exercise; Family engagement/empowerment) bundle have shown benefit in reducing delirium prevalence in the ICU2. [3] The patient tried to speak during the spontaneous awakening trials and breathing trials for weaning off mechanical ventilation. [4] , Assess, Prevent and Manage Pain; Both Spontaneous Awakening/Breathing Trials; Choice of analgesia and sedation; Delirium: Assess, Prevent, Manage; Early Mobility; Family engagement) is a popular topic in critical care and cardiac surgery. [5]PSV (圧力サポート = 8 cmH2O) と NAVA (ゲイン = 5 cmH2O/μV、吸気トリガー = 0) を比較するための 2 つの短い (15 分) 呼吸試験。 [1] この施設固有のガイドラインは、必要に応じてボーラスを増やし、非ベンゾジアゼピン注入、毎日の鎮静中断、および自発的覚醒（SAT）と呼吸試験（SBT）の組み合わせによるプロトコル化された鎮静を強調しました。 [2] ABCDEF の完全遵守などの非薬理学的介入 (痛みの評価、予防、および管理; 自然覚醒と呼吸の両方の試験: 鎮痛と鎮静の選択; せん妄の評価、予防、および管理; 早期の可動性と運動; 家族の関与/エンパワーメント) バンドルは、ICU でのせん妄の有病率を減らすのに有益であることが示されています2。 [3] 患者は、人工呼吸器から離脱するための自然覚醒試験および呼吸試験中に話そうとしました。 [4] 、痛みの評価、予防、管理。自然覚醒/呼吸試験の両方。鎮痛と鎮静の選択;せん妄：評価、予防、管理。初期のモビリティ;家族の関与）は、救命救急や心臓手術で人気のあるトピックです。 [5]
intensive care unit 集中治療室
Objective To investigate management and implementation of the “awakening and breathing trials, choice of drugs, delirium management, and early exercise/mobility” (ABCDE) bundle in the pediatric intensive care unit (PICU) in southwestern China Methods A self-designed questionnaire for determining implementation of the ABCDE bundle was distributed to healthcare professionals in the PICU. [1] Although growing evidence supports the safety and effectiveness of the ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment), intensive care unit providers often struggle with how to reliably and consistently incorporate this interprofessional, evidence-based intervention into everyday clinical practice. [2] &NA; The ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment) improves intensive care unit patient‐centered outcomes and promotes interprofessional teamwork and collaboration. [3] Background: The awakening and breathing coordination of daily sedation and ventilator removal trials, delirium monitoring and management, and early mobility and exercise (ABCDE) and assessment, prevent and manage pain, both spontaneous awakening and spontaneous breathing trials, choice of analgesia and sedation, assess, prevent and manage delirium, early mobility and exercise, family engagement (ABCDEF) bundles are part of the science of the liberation of the intensive care unit (ICU). [4]中国南西部の小児集中治療室（PICU）の「目覚めおよび呼吸試験、薬物の選択、せん妄管理、早期運動/モビリティ）（ABCDE）の管理と実施を調査する目的 [1] ABCDEF バンドルの安全性と有効性を裏付ける証拠が増えていますが (A、痛みの評価、予防、および管理、B、自発的覚醒と自発呼吸の両方の試験、C、鎮痛薬と鎮静剤の選択、D、せん妄: 評価、予防、および管理、E、初期の可動性と運動、F、家族の関与とエンパワーメント)、集中治療室のプロバイダーは、この専門家間のエビデンスに基づく介入を日常の臨床診療に確実かつ一貫して組み込む方法に苦労することがよくあります。 [2] &NA; ABCDEF バンドル (A、痛みの評価、予防、管理、B、自発的覚醒と自発呼吸の両方の試験、C、鎮痛薬と鎮静の選択、D、せん妄: 評価、予防、管理、E、早期の可動性と運動、 F、家族の関与とエンパワーメント）は、集中治療室の患者中心の転帰を改善し、専門職間のチームワークとコラボレーションを促進します。 [3] 背景：毎日の鎮静および人工呼吸器除去試験の覚醒と呼吸の調整、せん妄のモニタリングと管理、および早期可動性と運動（ABCDE）と評価、疼痛の予防と管理、自発的覚醒と自発呼吸試験の両方、鎮痛と鎮静の選択、せん妄の評価、予防、管理、早期の可動性と運動、家族の関与 (ABCDEF) バンドルは、集中治療室 (ICU) の解放の科学の一部です。 [4]
daily spontaneous awakening
A process care bundle (endotracheal intubation with subglottic suctioning, head‐of‐bed elevation ≥30°, target sedation scores, daily spontaneous awakening trials, spontaneous breathing trials), daily delirium assessment, and an early mobility protocol were instituted. [1] Potential interventions to prevent VAEs include avoiding intubation, minimizing sedation, paired daily spontaneous awakening and breathing trials, conservative fluid management, conservative transfusion thresholds, low tidal volume ventilation, and early mobility. [2] Potential strategies to prevent VAEs include minimizing sedation, paired daily spontaneous awakening and breathing trials, early mobility, conservative fluid management, conservative transfusion thresholds, and low tidal-volume ventilation. [3] More specific analgesic and sedation strategies, daily spontaneous awakening and breathing trials, early extubation and mobilization, and measures to decrease ICU delirium are being implemented resulting in improved outcomes. [4]プロセス ケア バンドル（声門下吸引を伴う気管内挿管、30°以上のベッド頭挙上、目標鎮静スコア、毎日の自発的覚醒試験、自発呼吸試験）、毎日のせん妄評価、および早期可動性プロトコルが開始されました。 [1] VAE を予防するための潜在的な介入には、挿管の回避、鎮静の最小化、毎日の自然覚醒と呼吸試験の組み合わせ、保守的な輸液管理、保守的な輸血閾値、低一回換気量換気、および早期の可動性が含まれます。 [2] VAE を予防するための潜在的な戦略には、鎮静を最小限に抑えること、毎日の自発覚醒と呼吸試験の組み合わせ、早期の可動性、保守的な水分管理、保守的な輸血閾値、および低一回換気量換気が含まれます。 [3] より具体的な鎮痛および鎮静戦略、毎日の自発的な覚醒および呼吸試験、早期の抜管および動員、ICU せん妄を減少させるための対策が実施され、転帰が改善されています。 [4]
regular pain assessment 定期的な痛みの評価
Methods Nutrition therapy was evaluated during a world-wide one-day prevalence study focused on implementation of the ABCDEF bundle (A: regular pain assessment, B: both spontaneous awakening and breathing trials, C: regular sedation assessment, D: regular delirium assessment, E: early mobility and exercise, and F: family engagement and empowerment) during the COVID-19 pandemic. [1] Implementation rates were: entire bundle (without COVID-19: 0% and with COVID-19: 1%), Element A (regular pain assessment: 64 and 55%), Element B (both spontaneous awakening and breathing trials: 17 and 10%), Element C (regular sedation assessment: 45 and 61%), Element D (regular delirium assessment: 39 and 35%), Element E (exercise: 22 and 25%), Element F (family engagement/empowerment: 16 and 30%), and ICU diary (17 and 21%). [2] Each element was implemented for the following percentages of patients: elements A (regular pain assessment), 45%; B (both spontaneous awakening and breathing trials), 28%; C (regular sedation assessment), 52%; D (regular delirium assessment), 35%; E (early mobility and exercise), 47%; and F (family engagement and empowerment), 16%. [3]方法 [1] 実装率は次のとおりでした：バンドル全体（Covid-19：0％、Covid-19：1％のない）、要素A（通常の痛み評価：64および55％）、要素B（自発的覚醒および呼吸試験：17および10の両方 [2] nan [3]
pressure support ventilation プレッシャーサポート換気
Several questions arise when the weaning process begins: (1) which ventilation mode should be preferred to enable the respiratory muscles to both rest and not to waste? [9]; (2) when to start spontaneous breathing trials (SBT)?; (3) should positive pressure support (PSV) or T-piece trials be used for SBT?; (4) which respiratory parameters should be used to predict successful extubation?; and finally (5) is there any place for non-invasive mechanical ventilation (NIV) or high-flow nasal oxygenation to increase extubation success rate? Synchronized intermittent mandatory ventilation is now discouraged since this mode was associated with prolonged weaning [8, 10], and pressure support ventilation (PSV) should be preferred over assisted ventilation when weaning begins [8, 11, 12]. [1] METHODS One hundred mechanically ventilated patients underwent daily 30-min spontaneous breathing trials (SBTs) under pressure support ventilation of 6 cm H2O and end-expiratory pressure of 0 cm H2O until the SBT was considered successful and followed by extubation. [2]離乳プロセスが始まると、いくつかの疑問が生じます。（1）呼吸筋が休息し、無駄にならないようにするために、どの換気モードが優先されるべきですか？ [1] 方法 [2]
Spontaneou Breathing Trials 自発呼吸トライアル
We included patients extubated to HFNC following spontaneous breathing trials. [1] Contrary to current decision-making criteria for extubation based on Spontaneous Breathing Trials, the classifier predictors only require monitor data, medical entry records and patient demographics. [2] Several questions arise when the weaning process begins: (1) which ventilation mode should be preferred to enable the respiratory muscles to both rest and not to waste? [9]; (2) when to start spontaneous breathing trials (SBT)?; (3) should positive pressure support (PSV) or T-piece trials be used for SBT?; (4) which respiratory parameters should be used to predict successful extubation?; and finally (5) is there any place for non-invasive mechanical ventilation (NIV) or high-flow nasal oxygenation to increase extubation success rate? Synchronized intermittent mandatory ventilation is now discouraged since this mode was associated with prolonged weaning [8, 10], and pressure support ventilation (PSV) should be preferred over assisted ventilation when weaning begins [8, 11, 12]. [3] Objectives: We aimed to evaluate an effect of different techniques of spontaneous breathing trials (SBT) on a success rate of extubation in the patients with EFL. [4] Objective To describe practice variation in IMV discontinuation internationally, associations between initial discontinuation events and outcomes, and factors associated with the use of select discontinuation strategies and failed initial spontaneous breathing trials (SBTs). [5] Background Spontaneous breathing trials (SBTs) have been shown to improve outcomes in critically ill patients. [6] BACKGROUND Typically, patients with progressive neuromuscular disorders (NMDs) develop acute respiratory failure (ARF), are intubated, and when failing spontaneous breathing trials (SBTs) undergo a tracheotomy and receive tracheostomy mechanical ventilation (TMV). [7] COT, NPPV, and HFNC use were assessed in patients who were aged ≥ 16 years, underwent invasive mechanical ventilation for > 12 h for acute respiratory failure, and were scheduled for extubation after spontaneous breathing trials. [8] Spontaneous breathing trials were performed in 38. [9] METHODS One hundred mechanically ventilated patients underwent daily 30-min spontaneous breathing trials (SBTs) under pressure support ventilation of 6 cm H2O and end-expiratory pressure of 0 cm H2O until the SBT was considered successful and followed by extubation. [10] INTRODUCTION Our aim was to present the initial experience with a protocol-driven early extubation strategy and to identify risk factors associated with failed spontaneous breathing trials within 12 hours after surgery. [11] METHODS This prospective observational study of previously independent adults age 55 or older, undergoing mechanical ventilation for up to 7 days, recruited participants at the time of spontaneous breathing trials or < 24 hours after extubation. [12] Spontaneous breathing trials induced severe tachypnoea; thus, tracheostomy was performed. [13] Objectives Although spontaneous breathing trials (SBTs) are standard of care to extubation readiness, no tool exists that optimises prediction and standardises assessment. [14] Methods We conducted a retrospective chart review of patients with spontaneous intracerebral haemorrhage (sICH) who underwent spontaneous breathing trials from 2018 to 2020. [15] Providers monitor for alerts suggestive of possible ventilator-associated events and advise when patients should undergo spontaneous breathing trials. [16] 4,5 Extubation readiness is primarily steered by clinical judgement and is supported by measures like spontaneous breathing trials (SBT), minute ventilation tests and the extubation predictor calculator. [17] This study aims to determine the effectiveness of the Assess, prevent and manage pain; Both spontaneous awakening and spontaneous breathing trials; Choice of sedation and analgesia; Delirium: assess, prevent and manage; Early mobility and exercise; Family engagement and empowerment (ABCDEF) bundle in reducing ICU-related short-term and long-term consequences of critical illness through a randomised controlled trial (RCT). [18] Surgical admissions, spontaneous breathing trials, early mobility, vasopressors, red blood cell units transfusion, type of sedation (continuous vs intermittent), benzodiazepine use for >3 d, and pharmacologic paralysis were not associated with pediatric VAE, whereas the use of continuous short-acting sedative-analgesic agents was identified as a strong protective factor against pediatric VAE (hazard ratio 0. [19] BACKGROUND Spontaneous breathing trials (SBTs) are an evidence-based way of identifying patients ready for mechanical ventilation (MV) liberation. [20] by using frequent sedation assessment, targeted sedation, or bundles such as the ABCDEF (Assess, prevent, & manage pain; Both spontaneous awakening and spontaneous breathing trials; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment) bundle. [21] There were eleven extubations and seven decannulations to CNVS despite failure to pass spontaneous breathing trials. [22] Effect of pressure support vs t-piece ventilation strategies during spontaneous breathing trials on successful extubation among patients receiving mechanical ventilation: a randomized clinical trial. [23] Additionally, daily pauses in sedation should be implemented to coincide with daily spontaneous breathing trials for all intubated patients. [24] ” This iatrogenic state drives these patients into deep sleep stages that impact spontaneous breathing trials, weaken immunity, and lead to unwarranted investigations and interventions. [25] To achieve this goal, the bundle includes assessments for pain, delirium, and readiness to stop sedation and to start spontaneous breathing trials. [26] Methods Before and at the end of 62 spontaneous breathing trials (SBT) performed in 42 patients, we prospectively assessed lung ultrasound on four anterior chest wall points. [27] Importance Spontaneous breathing trials (SBTs) are used to determine extubation readiness in extremely preterm neonates (gestational age ≤28 weeks), but these trials rely on empirical combinations of clinical events during endotracheal continuous positive airway pressure (ET-CPAP). [28] Objectives: In this study (SLEEWE [Effect of Sleep Disruption on the Outcome of Weaning from Mechanical Ventilation]), we aimed to investigate polysomnographic indexes as well as a continuous index for evaluating sleep depth, the odds ratio product (ORP), to determine whether abnormal sleep or wakefulness is associated with the outcome of spontaneous breathing trials (SBTs). [29] Objectives: Daily ICU interprofessional team rounds, which incorporate the ICU Liberation (“A” for Assessment, Prevention, and Manage Pain; “B” for Both Spontaneous Awakening Trials and Spontaneous Breathing Trials; “C” for Choice of Analgesia and Sedation; “D” for Delirium Assess, Prevent, and Manage; “E” for Early Mobility and Exercise; “F” for Family Engagement and Empowerment [ABCDEF]) Bundle, support both the care coordination and regular provider communication necessary for Bundle execution. [30] Introduction In addition to the well-documented factors that contribute to weaning failure, increased energy demands of the respiratory muscles during spontaneous breathing trials (SBTs) might not be met by sufficient increases in energy supplies. [31] Several measures are recognized as being useful to prevent VAP, and these are usually grouped in a VAP bundle (ie, avoiding intubation or re-intubation whenever possible; head of bed elevation; hand hygiene; shortening ventilation through sedation interruptions, spontaneous breathing trials, or thromboembolic prophylaxis). [32] Adult ICU patients, aged 18 and over who were mechanically ventilated and candidates for weaning to spontaneous breathing trials were included in the review. [33] Although growing evidence supports the safety and effectiveness of the ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment), intensive care unit providers often struggle with how to reliably and consistently incorporate this interprofessional, evidence-based intervention into everyday clinical practice. [34] METHODS In a single-center, prospective study, patients receiving mechanical ventilation were randomly assigned to 1 of 3 groups (T-tube, pressure support ventilation, or high-flow oxygen) during 2-hour spontaneous breathing trials in a 14-day study. [35] ICU nurses were asked about their demographic characteristics, educational background, and specialty certification, as well as their knowledge and attitudes toward EBPs in general and three specific EBPs: daily interruption of sedation (DIS), spontaneous breathing trials (SBTs), and lung-protective ventilation (LPV). [36] A process care bundle (endotracheal intubation with subglottic suctioning, head‐of‐bed elevation ≥30°, target sedation scores, daily spontaneous awakening trials, spontaneous breathing trials), daily delirium assessment, and an early mobility protocol were instituted. [37] Two weeks later, Tom shows only agonal respirations on spontaneous breathing trials but has remained stable on the ventilator. [38] Therefore, this essential component of the management of patients on ECMO is highly variable and often lacks of a systematic approach [5], analogously to the weaning protocols and spontaneous breathing trials used for liberation from mechanical ventilation [6]. [39] The weaning management application areas included (1) prediction of successful spontaneous breathing trials (SBTs), (2) prediction of successful extubation, (3) prediction of arterial blood gases, and (4) ventilator setting and oxygenation-adjustment advisory systems. [40] BackgroundEndotracheal tubes used for neonates are not as resistant to breathing as originally anticipated; therefore, spontaneous breathing trials (SBTs) with continuous positive airway pressure (CPAP), without pressure support (PS), are recommended. [41] Learning Objectives: The value of spontaneous breathing trials (SBT) is well-established. [42] Importance Daily spontaneous breathing trials (SBTs) are the best approach to determine whether patients are ready for disconnection from mechanical ventilation, but mode and duration of SBT remain controversial. [43] &NA; The ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment) improves intensive care unit patient‐centered outcomes and promotes interprofessional teamwork and collaboration. [44] At this juncture, and based on the limited evidence to date, it appears that incorporating daily sedation interruptions and spontaneous breathing trials are the factors most likely to reduce VAEs. [45] The length of time to start spontaneous breathing trials with a T-piece was greater in Group I than in Group II (27+-11 hours, 16+-11 hours, respectively; p<0. [46] Difficulty in weaning was defined as follows: the need for more than three spontaneous breathing trials or more than 1 week to achieve successful weaning. [47] Daily awakening and spontaneous breathing trials and early mobilization have shown benefit in both cognitive and functional outcomes. [48] The levels of knowledge and self-reported adherence regarding spontaneous breathing trials were 61. [49] Background: The awakening and breathing coordination of daily sedation and ventilator removal trials, delirium monitoring and management, and early mobility and exercise (ABCDE) and assessment, prevent and manage pain, both spontaneous awakening and spontaneous breathing trials, choice of analgesia and sedation, assess, prevent and manage delirium, early mobility and exercise, family engagement (ABCDEF) bundles are part of the science of the liberation of the intensive care unit (ICU). [50]自発的な呼吸試験に続いて、HFNCに抜管された患者を含めました。 [1] 自然呼吸試験に基づく抜管の現在の意思決定基準とは反対に、分類器予測因子には、モニターデータ、医療エントリー記録、患者の人口統計のみが必要です。 [2] 離乳プロセスが始まると、いくつかの疑問が生じます。（1）呼吸筋が休息し、無駄にならないようにするために、どの換気モードが優先されるべきですか？ [3] nan [4] nan [5] nan [6] nan [7] nan [8] nan [9] 方法 [10] nan [11] nan [12] nan [13] nan [14] nan [15] nan [16] nan [17] nan [18] nan [19] nan [20] nan [21] nan [22] nan [23] nan [24] nan [25] この目標を達成するために、このバンドルには、痛み、せん妄、および鎮静を停止して自発呼吸試験を開始するための準備の評価が含まれています。 [26] 方法 42 人の患者で行われた 62 の自発呼吸試験 (SBT) の前と最後に、前胸壁の 4 点で肺の超音波を前向きに評価した。 [27] 重要性 自発呼吸試験 (SBT) は、超早産児 (妊娠 28 週以下) の抜管準備を判断するために使用されますが、これらの試験は、気管内持続気道陽圧 (ET-CPAP) 中の臨床事象の経験的な組み合わせに依存しています。 [28] 目的: この研究 (SLEEWE [人工呼吸器からの離脱の結果に対する睡眠障害の影響]) では、睡眠ポリグラフの指標と、睡眠の深さを評価するための連続的な指標であるオッズ比積 (ORP) を調査することを目的として、異常な睡眠または覚醒が自発呼吸試験（SBT）の結果と関連しているかどうか。 [29] 目的: ICU 解放を取り入れた毎日の ICU 専門家チームラウンド (「A」は痛みの評価、予防、管理、「B」は自然覚醒試験と自発呼吸試験の両方、「C」は鎮痛と鎮静の選択、「 D" はせん妄の評価、予防、および管理、"E" は早期可動性と運動、"F" は家族の関与とエンパワーメント [ABCDEF]) バンドルは、バンドルの実行に必要なケアの調整と定期的な医療提供者とのコミュニケーションの両方をサポートします。 [30] はじめに 離乳の失敗に寄与する十分に文書化された要因に加えて、自発呼吸試験 (SBT) 中の呼吸筋のエネルギー需要の増加は、エネルギー供給の十分な増加によって満たされない可能性があります。 [31] いくつかの手段が VAP の予防に有効であると認識されており、これらは通常 VAP バンドルにグループ化されています (つまり、可能な限り挿管または再挿管を避ける、ベッドの頭を上げる、手指衛生、鎮静中断による換気の短縮、自発呼吸の試行、または血栓塞栓予防）。 [32] 18 歳以上の成人の ICU 患者で人工呼吸器を装着しており、自発呼吸試験への離乳の候補者がレビューに含まれていました。 [33] ABCDEF バンドルの安全性と有効性を裏付ける証拠が増えていますが (A、痛みの評価、予防、および管理、B、自発的覚醒と自発呼吸の両方の試験、C、鎮痛薬と鎮静剤の選択、D、せん妄: 評価、予防、および管理、E、初期の可動性と運動、F、家族の関与とエンパワーメント)、集中治療室のプロバイダーは、この専門家間のエビデンスに基づく介入を日常の臨床診療に確実かつ一貫して組み込む方法に苦労することがよくあります。 [34] 方法 単一施設の前向き研究では、14 日間の研究で 2 時間の自発呼吸試験中に、機械的換気を受けている患者が 3 つのグループ (T チューブ、圧力サポート換気、または高流量酸素) のうちの 1 つに無作為に割り当てられました。 [35] ICU 看護師は、人口統計学的特徴、学歴、専門資格認定、および一般的な EBP と 3 つの特定の EBP (毎日の鎮静中断 (DIS)、自発呼吸試行 (SBT)、および肺-保護換気（LPV）。 [36] プロセス ケア バンドル（声門下吸引を伴う気管内挿管、30°以上のベッド頭挙上、目標鎮静スコア、毎日の自発的覚醒試験、自発呼吸試験）、毎日のせん妄評価、および早期可動性プロトコルが開始されました。 [37] 2 週間後、Tom は自発呼吸試験で苦悶呼吸のみを示しましたが、人工呼吸器では安定したままです。 [38] したがって、ECMO を使用している患者の管理に不可欠なこの要素は、人工呼吸器からの解放に使用されるウィーニング プロトコルや自発呼吸の試験と同様に、非常に多様であり、体系的なアプローチが欠けていることがよくあります [6]。 [39] ウィーニング管理アプリケーション領域には、(1) 成功した自発呼吸試行 (SBT) の予測、(2) 成功した抜管の予測、(3) 動脈血ガスの予測、(4) 人工呼吸器の設定と酸素化調整の助言システムが含まれます。 [40] 背景新生児に使用される気管内チューブは、当初予想されていたほど呼吸に対する耐性がありません。したがって、持続的気道陽圧 (CPAP) を使用し、圧力サポート (PS) を使用しない自発呼吸試験 (SBT) が推奨されます。 [41] 学習目標: 自発呼吸試験 (SBT) の価値は十分に確立されています。 [42] 重要性 毎日の自発呼吸試験 (SBT) は、患者が人工呼吸器から切断する準備ができているかどうかを判断するための最良のアプローチですが、SBT のモードと期間は依然として議論の余地があります。 [43] &NA; ABCDEF バンドル (A、痛みの評価、予防、管理、B、自発的覚醒と自発呼吸の両方の試験、C、鎮痛薬と鎮静の選択、D、せん妄: 評価、予防、管理、E、早期の可動性と運動、 F、家族の関与とエンパワーメント）は、集中治療室の患者中心の転帰を改善し、専門職間のチームワークとコラボレーションを促進します。 [44] 現時点では、今日までの限られたエビデンスに基づくと、毎日の鎮静中断と自発呼吸試験を組み込むことが、VAE を減少させる可能性が最も高い要因であるように思われます。 [45] T ピースを使用した自発呼吸の試行を開始するまでの時間は、グループ II よりもグループ I の方が長かった (それぞれ 27+-11 時間、16+-11 時間; p<0. [46] 離乳の難しさは、次のように定義されました: 離乳を成功させるには、3 回以上の自発呼吸試行または 1 週間以上の試行が必要です。 [47] 毎日の覚醒と自発呼吸の試験、および早期動員は、認知と機能の両方の結果に利益をもたらすことが示されています。 [48] 自発呼吸試験に関する知識レベルと自己申告による遵守率は 61 でした。 [49] 背景：毎日の鎮静および人工呼吸器除去試験の覚醒と呼吸の調整、せん妄のモニタリングと管理、および早期可動性と運動（ABCDE）と評価、疼痛の予防と管理、自発的覚醒と自発呼吸試験の両方、鎮痛と鎮静の選択、せん妄の評価、予防、管理、早期の可動性と運動、家族の関与 (ABCDEF) バンドルは、集中治療室 (ICU) の解放の科学の一部です。 [50]