Evidence map›Paper›PMID 42618951›Full record

Trial reportCritical care (London, England)2026

Physiological comparison of high-flow oxygen via endotracheal tube and T-piece strategies during spontaneous breathing trials: a randomized crossover study.

Shan-Shan Xu, Rui-Zhi Zhang, Jun-Tong Liu, Lin Wang, Meng-Xue Hou, Xu An, Ming-Yue Miao, Hong-Liang Li, Yue-Fu Wang, Jian-Xin Zhou

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06816706 (Comparison of Physiological Effects of Two Types of High-Flow Tracheal Oxygen Versus T-Piece During Spontaneous Breathing Trials in Mechanically Ventilated Patients), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT06816706 narecruitingnot on this map

Comparison of Physiological Effects of Two Types of High-Flow Tracheal Oxygen Versus T-Piece During Spontaneous Breathing Trials in Mechanically Ventilated Patients

TypeinterventionalSponsorJian-Xin ZhouRan2025 to 2025Enrolled20ConditionsCritical Care, Oxygen Therapy, Mechanical VentilationArmsModified high flow tracheal oxygen-40L/min, Standard high flow tracheal oxygen-40L/min, T-piece, Modified high-flow tracheal oxygen-60L/min, Standard high-flow tracheal oxygen-60 L/min
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Shan-Shan Xu *Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Rui-Zhi Zhang *Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Jun-Tong LiuDepartment of Critical Care Medicine, Beijing Fengtai You'anmen Hospital, Beijing, China.
Lin WangDepartment of Critical Care Medicine, Beijing Fengtai You'anmen Hospital, Beijing, China.
Meng-Xue HouEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Xu AnEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Ming-Yue MiaoEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Hong-Liang LiEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Yue-Fu WangEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Jian-Xin ZhouEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China. zhoujx.cn@icloud.com.

Funding

Beijing Shijitan Hospital IIT2024-157-002
6 · The paper itself

Abstract

backgroundThe optimal spontaneous breathing trial (SBT) strategy remains uncertain because commonly used approaches involve distinct physiological trade-offs. Pressure support ventilation (PSV) may reduce inspiratory effort, whereas T-piece trials more closely approximate unsupported breathing after extubation. Neither approach has shown clear superiority for extubation outcomes. High-flow oxygen (HFO) delivered via endotracheal tube has been proposed as an alternative SBT strategy, but the physiological effects remain insufficiently defined.

methodsIn a randomized crossover physiological study, patients receiving mechanical ventilation for at least 24 h and deemed ready for weaning underwent five SBT conditions: T-piece and four HFO via endotracheal tube settings combining two interfaces with different expiratory port diameters (9.8 and 6.9 mm) and two flow rates (40 and 60 L/min). Airway and esophageal pressures, respiratory variables, and electrical impedance tomography parameters were measured during baseline mechanical ventilation and under each SBT condition. Esophageal pressure was also measured after extubation for comparison with post-extubation inspiratory effort. A complementary bench study assessed 24 simulated conditions across four interface diameters and six flow rates.

resultsTwenty patients were analyzed. Compared with T-piece, HFO-6.9 at 60 L/min produced the largest increases in mean expiratory airway pressure (median paired difference, 7.0 cm H

conclusionsDuring SBT, HFO via endotracheal tube generated flow- and expiratory port diameter-dependent increases in airway pressure and lung volume, with lower dynamic transpulmonary driving pressure and improved oxygenation; no statistically significant difference in ΔPes was observed across HFO, T-piece, and post-extubation measurements. These findings support tracheal HFO as a physiologically distinct SBT strategy that may inform individualized SBT selection. Its relationship to clinical outcomes requires further evaluation.

trial registrationClinicalTrials.gov (NCT06816706). Registered on 6 February 2025.

Indexed as

Intubation, IntratrachealOxygenOxygen Inhalation TherapyAgedCross-Over StudiesFemaleHumansMaleMiddle AgedRespiration, ArtificialVentilator WeaningOxygenElectrical impedance tomographyEsophageal pressureHigh-flow oxygen via endotracheal tubeSpontaneous breathing trial

Identifiers

PMID42618951
PMCPMC13488186

What OpenQuestion holds

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Registered trials

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.