Despite prior publications of clinical practice guidelines related to ventilator liberation, some questions remain unanswered. Many of these questions relate to the details of bedside implementation. We, therefore, formed a guidelines committee of individuals with experience and knowledge of ventilator liberation as well as a medical librarian. Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, we make the following recommendations: (1) We suggest that calculation of a rapid shallow breathing index is not needed to determine readiness for a spontaneous breathing trial (SBT) (conditional; moderate certainty); (2) We suggest that SBTs can be conducted with or without pressure support ventilation (conditional recommendation, moderate certainty); (3) We suggest a standardized approach to assessment and, if appropriate, completion of an SBT before noon each day (conditional recommendation, very low certainty); and (4) We suggest that F_IO2 should not be increased during an SBT (conditional recommendation, very low certainty). These recommendations are intended to assist bedside clinicians to liberate adult critically ill patients more rapidly from mechanical ventilation.

中文翻译：

---

AARC 临床实践指南：摆脱成人机械通气的自主呼吸试验。


尽管之前发布了与呼吸机解放相关的临床实践指南，但仍有一些问题没有得到解答。其中许多问题都与床边实施的细节有关。因此，我们成立了一个指导委员会，由具有呼吸机解放经验和知识的个人以及医学图书馆员组成。使用建议评估、制定和评估分级 (GRADE) 方法，我们提出以下建议： (1) 我们建议不需要计算浅快呼吸指数来确定自主呼吸试验 (SBT) 的准备情况（有条件）中等确定性）； （2）我们建议SBT可以在有或没有压力支持通气的情况下进行（有条件推荐，中等确定性）； (3) 我们建议采用标准化方法进行评估，如果合适，每天中午之前完成 SBT（有条件推荐，确定性非常低）； (4) 我们建议在 SBT 期间不应增加 F _{IO 2} （有条件推荐，确定性非常低）。这些建议旨在帮助床边临床医生更快地将成年危重患者从机械通气中解放出来。