Spontaneous breathing trials as predictors of extubation outcomes in neurocritical care: insights from the ENIO study
Issued Date
2026-01-01
Resource Type
ISSN
03424642
eISSN
14321238
Scopus ID
2-s2.0-105027793482
Pubmed ID
41528453
Journal Title
Intensive Care Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
Intensive Care Medicine (2026)
Suggested Citation
Battaglini D., Taran S., Gualdi F., Cinotti R., Asehnoune K., Loggini A., Montagnani L., Rocco P.R.M., Schultz M.J., Patroniti N.A., Robba C., Stevens R., Pirracchio R., Peredo N., Cerda R., Fong N., Digitale J., Azab M., Reza S., Elhadi M., Piagnerelli M., Elbuzidi A.S., Badenes R., Ueno Y., Ioakeimidou A., Alvarez P., Godoy D., Kaye C., Schultz M., Gurjar M., Haënggi M., Mijangos J., Samal S., Mishra S., Agrawal A., Saxena S., Mouclier N., Gergaud S., Lasocki S., Masseret E., Launey Y., Hashim A., Abdelaty M., Akkari A., van der Jagt M., van Steenkiste J., Grillot N., Hourmant Y., Sklavou C., Chantziara V., Papadas C., Hossain M.M., Reza S.T., Arellano A., Gasca G., Deewan Y., Agarwal S., Panda S., Jain G., Rodie-Talbere P.A., Robert-Edan V., Jha A., Yadav G., García-Ramos J., Galicia-Espinosa F., van Meenen D., Azzam A.Y., Azab M.A., Nubert Castillo V., Velarde Pineda A., Welbourne J., Coombs A., Ahmed H., Geslain M., Huet O., Brochet B., Legros V., Trujillo R., Chavez M.J., Vetrugno L., Deana C., Palma D., Cracchiolo A., Ghula M., Khaled A., Yahya H., Prol-Silva E., Pérez-Torres D., Compagnon B., Geeraerts T., Lopez-Morales M., Porter J., Barbosa-Camacho F., Miranda-Ackerman R., Baronia A., Georges D., Biais M., Orquera J., Lamot L., Gomez Haedo M. Spontaneous breathing trials as predictors of extubation outcomes in neurocritical care: insights from the ENIO study. Intensive Care Medicine (2026). doi:10.1007/s00134-025-08258-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114516
Title
Spontaneous breathing trials as predictors of extubation outcomes in neurocritical care: insights from the ENIO study
Author(s)
Battaglini D.
Taran S.
Gualdi F.
Cinotti R.
Asehnoune K.
Loggini A.
Montagnani L.
Rocco P.R.M.
Schultz M.J.
Patroniti N.A.
Robba C.
Stevens R.
Pirracchio R.
Peredo N.
Cerda R.
Fong N.
Digitale J.
Azab M.
Reza S.
Elhadi M.
Piagnerelli M.
Elbuzidi A.S.
Badenes R.
Ueno Y.
Ioakeimidou A.
Alvarez P.
Godoy D.
Kaye C.
Schultz M.
Gurjar M.
Haënggi M.
Mijangos J.
Samal S.
Mishra S.
Agrawal A.
Saxena S.
Mouclier N.
Gergaud S.
Lasocki S.
Masseret E.
Launey Y.
Hashim A.
Abdelaty M.
Akkari A.
van der Jagt M.
van Steenkiste J.
Grillot N.
Hourmant Y.
Sklavou C.
Chantziara V.
Papadas C.
Hossain M.M.
Reza S.T.
Arellano A.
Gasca G.
Deewan Y.
Agarwal S.
Panda S.
Jain G.
Rodie-Talbere P.A.
Robert-Edan V.
Jha A.
Yadav G.
García-Ramos J.
Galicia-Espinosa F.
van Meenen D.
Azzam A.Y.
Azab M.A.
Nubert Castillo V.
Velarde Pineda A.
Welbourne J.
Coombs A.
Ahmed H.
Geslain M.
Huet O.
Brochet B.
Legros V.
Trujillo R.
Chavez M.J.
Vetrugno L.
Deana C.
Palma D.
Cracchiolo A.
Ghula M.
Khaled A.
Yahya H.
Prol-Silva E.
Pérez-Torres D.
Compagnon B.
Geeraerts T.
Lopez-Morales M.
Porter J.
Barbosa-Camacho F.
Miranda-Ackerman R.
Baronia A.
Georges D.
Biais M.
Orquera J.
Lamot L.
Gomez Haedo M.
Taran S.
Gualdi F.
Cinotti R.
Asehnoune K.
Loggini A.
Montagnani L.
Rocco P.R.M.
Schultz M.J.
Patroniti N.A.
Robba C.
Stevens R.
Pirracchio R.
Peredo N.
Cerda R.
Fong N.
Digitale J.
Azab M.
Reza S.
Elhadi M.
Piagnerelli M.
Elbuzidi A.S.
Badenes R.
Ueno Y.
Ioakeimidou A.
Alvarez P.
Godoy D.
Kaye C.
Schultz M.
Gurjar M.
Haënggi M.
Mijangos J.
Samal S.
Mishra S.
Agrawal A.
Saxena S.
Mouclier N.
Gergaud S.
Lasocki S.
Masseret E.
Launey Y.
Hashim A.
Abdelaty M.
Akkari A.
van der Jagt M.
van Steenkiste J.
Grillot N.
Hourmant Y.
Sklavou C.
Chantziara V.
Papadas C.
Hossain M.M.
Reza S.T.
Arellano A.
Gasca G.
Deewan Y.
Agarwal S.
Panda S.
Jain G.
Rodie-Talbere P.A.
Robert-Edan V.
Jha A.
Yadav G.
García-Ramos J.
Galicia-Espinosa F.
van Meenen D.
Azzam A.Y.
Azab M.A.
Nubert Castillo V.
Velarde Pineda A.
Welbourne J.
Coombs A.
Ahmed H.
Geslain M.
Huet O.
Brochet B.
Legros V.
Trujillo R.
Chavez M.J.
Vetrugno L.
Deana C.
Palma D.
Cracchiolo A.
Ghula M.
Khaled A.
Yahya H.
Prol-Silva E.
Pérez-Torres D.
Compagnon B.
Geeraerts T.
Lopez-Morales M.
Porter J.
Barbosa-Camacho F.
Miranda-Ackerman R.
Baronia A.
Georges D.
Biais M.
Orquera J.
Lamot L.
Gomez Haedo M.
Author's Affiliation
University of Toronto Faculty of Medicine
Universidade Federal do Rio de Janeiro
Università degli Studi di Genova
Amsterdam UMC - University of Amsterdam
Medizinische Universität Wien
IRCCS San Martino Polyclinic Hospital
Nuffield Department of Medicine
CHU de Nantes
Institute of Health Policy, Management and Evaluation
SIU School of Medicine
Mahidol Oxford Tropical Medicine Research Unit
Brain and Spine Institute
Universidade Federal do Rio de Janeiro
Università degli Studi di Genova
Amsterdam UMC - University of Amsterdam
Medizinische Universität Wien
IRCCS San Martino Polyclinic Hospital
Nuffield Department of Medicine
CHU de Nantes
Institute of Health Policy, Management and Evaluation
SIU School of Medicine
Mahidol Oxford Tropical Medicine Research Unit
Brain and Spine Institute
Corresponding Author(s)
Other Contributor(s)
Abstract
Purpose: In critically ill patients, extubation readiness is typically assessed using a spontaneous breathing trial (SBT). Among patients with acute brain injury (ABI), the optimal SBT method remains uncertain. Methods: We conducted a post-hoc analysis of the ENIO study (NCT03400904), including mechanically ventilated ABI patients with available SBT data, undergoing extubation attempt. SBTs were classified as T-piece, pressure support ventilation (PSV), or continuous positive airway pressure (CPAP). The primary outcome was extubation failure within 5 days. Associations between SBT modality and extubation failure were assessed using multivariable logistic regression and inverse probability of treatment weighting. Results: Of 1,512 patients enrolled in ENIO, 839 met the inclusion criteria, of whom 270 (32.2%) were female and 396 (47.2%) had traumatic brain injury as the cause of admission. SBTs were performed with PSV in 430 (51.3%), T-piece in 329 (39.2%), and CPAP in 80 (9.5%). SBT median duration was 60 min in PSV and T-piece, while 120 min in CPAP. Extubation failure occurred in 177 (21.1%) cases. In multivariable analyses, there was no significant association between SBT modality or duration and extubation outcome. Results were similar in ABI subgroup analyses. After inverse probability weighting, vigorous cough remained the only significant predictor of extubation success. Conclusions: In this large international ABI cohort, neither SBT mode nor duration was associated with extubation failure.