Weaning Protocol, Comparison of T-Tube and Continuous Positive Airway Pressure (CPAP) In Omdurman Teaching Hospital, Police Hospital, and Military Hospital- Khartoum -Sudan Duration: April 2010 _ February 2012.

Abstract

This study compares two methods of spontaneous breathing trials—T-tube and Continuous Positive Airway Pressure (CPAP)—to assess their effectiveness in weaning patients from mechanical ventilation. Conducted in Omdurman Teaching Hospital, Police Hospital, and Military Hospital in Sudan, —between April 2010 and February 2011. The research involved 64 patients who had been on mechanical ventilation for over 48 hours and were deemed ready for weaning based on clinical criteria. Patients were randomly assigned to undergo a 2-hour trial of spontaneous breathing using either a T-tube (Group A, n = 32) or CPAP (Group B, n = 32). Success in the trial was followed by extubation, with patients monitored for 48 hours for reintubation and associated outcomes.

Of the T-tube group, 78.1% (25/32) successfully completed the trial and were extubated, while 21.9% (7/32) failed. Among those extubated, 18.7% (6/32) required reintubation, leaving 59.4% (19/32) successfully extubated after 48 hours. In the CPAP group, 84.4% (27/32) were successfully extubated, with a failure rate of 15.6% (5/32). Reintubation was required for 12.6% (4/32) of the CPAP group, resulting in a successful extubation rate of 71.8% (23/32) after 48 hours. Although the difference in successful extubation rates was not statistically significant (59.4% vs. 71.8%, p = 0.10), the failure rate during the trial was significantly higher in the T-tube group (21.9% vs. 15.6%, p = 0.02). ICU mortality among reintubated patients was significantly higher compared to successfully extubated patients (23% vs. 4.5%, p = 0.004).

While the CPAP method showed slightly better outcomes, both T-tube and CPAP trials were effective methods for discontinuing ventilatory support in suitable patients. Further studies are recommended to refine and optimize these weaning techniques.