O papel do teste de respiração espontânea (TRE) no sucesso da extubação em unidade de terapia intensiva: uma revisão de literatura

Mechanical ventilation weaning and extubation are critical processes in the management of patients under invasive mechanical ventilation (IMV) in Intensive Care Units (ICU). Delays in withdrawing support are associated with increased infections and mortality, while extubation failure and subsequent reintubation drastically raise the risk of poor outcomes. The Spontaneous Breathing Trial (SBT) is established as the primary diagnostic tool to assess a patient's readiness to return to spontaneous breathing. This literature review aims to analyze the eligibility criteria, methods of conducting the SBT (T-piece versus Pressure Support Ventilation - PSV), and the main predictors of success and failure described in recent literature. Current evidence suggests a trend toward easier weaning with the use of low PSV and shorter trial durations (30 minutes), although the methodological choice should consider the patient's risk profile. In conclusion, the standardization and rigorous application of the SBT by multidisciplinary teams are essential to optimize success rates in extubation and reduce hospital stay.