Evidence map›Paper›PMID 35063453›Full record

ArticleChest2022

Factors Associated With Spontaneous Awakening Trial and Spontaneous Breathing Trial Performance in Adults With Critical Illness: Analysis of a Multicenter, Nationwide, Cohort Study.

Michele C Balas, Alai Tan, Lorraine C Mion, Brenda Pun, Jin Jun, Audrey Brockman, Jinjian Mu, E Wesley Ely, Eduard E Vasilevskis

Abstract readMulticenter Study
In one paragraph

Article in Chest, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Patient, Practice, and Organizational Factors Associated With Early Mobility Performance in Critically Ill Adults.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2024
    Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Michele C BalasCollege of Nursing, University of Nebraska Medical Center, Omaha, NE. Electronic address: mibalas@unmc.edu.
Alai TanCenters for Research and Health Analytics, College of Nursing, The Ohio State University, Columbus, OH.
Lorraine C MionCenters of Healthy Aging, Self-Management, and Complex Care, College of Nursing, The Ohio State University, Columbus, OH.
Brenda PunCritical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN.
Jin JunCenters of Healthy Aging, Self-Management, and Complex Care, College of Nursing, The Ohio State University, Columbus, OH.
Audrey BrockmanCollege of Nursing, The Ohio State University, Columbus, OH.
Jinjian MuCenters for Research and Health Analytics, College of Nursing, The Ohio State University, Columbus, OH.
E Wesley ElyCritical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN; Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; The Geriatric Research Education Clinical Center (GRECC), Veterans Administration Tennessee Valley Healthcare System, Nashville, TN; Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN; Center for Quality Aging, Vanderbilt University Medical Center, Nashville, TN.
Eduard E VasilevskisThe Geriatric Research Education Clinical Center (GRECC), Veterans Administration Tennessee Valley Healthcare System, Nashville, TN; Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Impact of a Novel Socially Assistive Robotic Architecture on Engaging Older Adults with Mild Cognitive Impairment, Alzheimer's Disease, and Related Dementia in Long Term Care SettingsR01AG062685 · NIA · VANDERBILT UNIVERSITY · PI SARKAR, NILANJAN, TATE, JUDITH ANN · 2020 to 2024
$3.5M
Determinants of Implementation Success Coordinating Ventilator, Early Ambulation and Rehabilitation Efforts in the ICU (DISCOVER-ICU) studyR01HL146781 · NHLBI · OHIO STATE UNIVERSITY · PI BALAS, MICHELE CHRISTINA, MION, LORRAINE C · 2019 to 2021
$1.3M
A Problem Solving Intervention for Post-ICU Cognitive Impairment in Older AdultsR03AG063276 · NIA · OHIO STATE UNIVERSITY · PI TATE, JUDITH ANN · 2019 to 2020
$312k
NCATS NIH HHS UL1 TR000445NHLBI NIH HHS R01 HL146781NIA NIH HHS R01 AG062685NIA NIH HHS R03 AG063276
6 · The paper itself

Abstract

backgroundBroad-scale adoption of spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) into everyday practice has been slow, and uncertainty exists regarding what factors facilitate or impede their routine delivery. RESEARCH QUESTION: What patient, practice, and pharmacologic factors are associated with SAT and SBT performance and to what extent do they predict overall SAT/SBT performance? STUDY DESIGN AND

methodsThis secondary analysis used data collected from a national quality improvement collaborative composed of 68 diverse ICUs. Adults with critical illness adults who received mechanical ventilation and/or continuously infused sedative medications were included. We performed mixed-effects logistic regression modeling, created receiver operating characteristic curves, and calculated the area under the curve (AUC).

resultsIncluded in the SAT and SBT analysis were 4,847 and 4,938 patients, respectively. In multivariable models controlling for admitting patient characteristics, factors independently associated with higher odds of a next-day SAT and SBT included physical restraint use (adjusted odds ratio [AOR], 1.63; 95% CI, 1.42-1.87; AOR, 1.83; 95% CI, 1.60-2.09), documented target sedation level (AOR, 1.68; 95% CI, 1.41-2.01; AOR, 1.46; 95% CI, 1.24-1.72), more frequent level of arousal assessments (AOR, 1.22; 95% CI, 1.03-1.43; AOR, 1.32; 95% CI, 1.13-1.54), and dexmedetomidine administration (AOR, 1.23; 95% CI, 1.05-1.45; AOR, 1.52; 95% CI, 1.27-1.80). Factors independently associated with lower odds of a next-day SAT and SBT included deep sedation/coma (AOR, 0.69; 95% CI, 0.60-0.80; AOR, 0.33; 95% CI, 0.28-0.37) and benzodiazepine (AOR, 0.83; 95% CI, 0.72-0.95; AOR, 0.67; 95% CI, 0.59-0.77) or ketamine (AOR, 0.34; 95% CI, 0.16-0.71; AOR, 0.40; 95% CI, 0.18-0.88) administration. Models incorporating admitting, daily, and unit variations displayed moderate discriminant accuracy in predicting next-day SAT (AUC, 0.73) and SBT (AUC, 0.72) performance.

interpretationThere are a number of modifiable factors associated with SAT/SBT performance that are amenable to the development and testing of implementation interventions.

Indexed as

Critical IllnessVentilator WeaningAdultCohort StudiesHumansIntensive Care UnitsRespiration, Artificialcritical caremechanical ventilationsedationspontaneous awakening trialspontaneous breathing trial

Identifiers

PMID35063453
PMCPMC9470738

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.