Spontaneous Breathing Trials Using Pressure Support or T-Piece in Overweight and Obese Patients

Inclusion criteria

• Patients had undergone intubation and mechanical ventilation for more than 24 hours prior to the first spontaneous breathing trial.

• Adult patients aged ≥ 18 years. 3. BMI ≥ 25 kg/m². 4. Meeting all the Inter national Consensus Conference on weaning criteria:

• Stable vital signs: heart rate < 140 beats/min, systolic blood pressure: 90-160 mmHg, and no use of vasopressors or use of minimal doses (<0.2 µg/kg per min).
• Respiratory rate ≤ 35 breaths/min.
• Adequate oxygenation, defined as either SpO2 > 90% with FiO2 ≤ 0.4, or PaO2/FiO2 > 150 mmHg with positive end-expiratory pressure (PEEP) ≤ 8 cmH2O.
• Adequate cough strength (MIP < -20 cmH2O).
• An awake state, defined as a score of Richmond Agitation-Sedation Scale between +1 and -2, or Glasgow Coma Scale > 8.
• No continuous sedation. 5. Informed consent provided by the patient or their relatives.

Exclusion criteria

• Patients with tracheostomy.
• Patients who had been admitted for traumatic brain injury.
• Patients who had preexisting peripheral neuromuscular disease (underlying myopathy or myasthenia gravis).
• Patients who had a do-not-reintubate order at the time of the initial spontaneous breathing trial were excluded
• Patients who have already undergone a first spontaneous breathing trial.
• Patients who had undergone extubation without an SBT
• Protected populations: pregnant or breastfeeding women, individuals under guardianship, or those under legal protection.
• Patients who refused to participate during the study.