Presión soporte, tubo en T y Presión Positiva Continua en Vía Aérea como métodos de destete ventilatorio en el paciente crítico adulto intubado

Objective: To analyze the existing literature on the use of T-tube, Support Pressure and Continuous Positive Airway Pressure as weaning methods in critically ill intubated adults and its influence on the extubation rates, the mortality rates, respiratory and hemodynamic values, weaning and MV duration, Intensive Care Unit stay and Ventilator Associated Pneumonia rates. Methods: A literature research was conducted from March to May 2018 in the specialized electronic databases in English (PubMed, CINAHL, WOS and Scopus) and Spanish (Dialnet, Biblioteca Cochrane Plus, Medes, CuidenPlus and Lilacs). Papers published between 2012 and 2018 were included in this review besides being published in English or Spanish and meeting CASPe criteria for clinical trials and systematic reviews. Nine articles were finally included in this literature review. Results: Of the total of nine papers that met the inclusion criteria, there were five clinical trials and four systematic reviews. Eight out of nine articles studied extubation rates; six papers studied mortality rates; five studied respiratory and hemodynamic parameters; five examined weaning and MV duration; two studied Intensive Care Unit stay; only one paper studied Ventilator Associated Pneumonia rates. Conclusions: T-tube has demonstrated to cause a larger alteration of respiratory and hemodynamic parameters during ventilator weaning compared to other methods. Nonetheless, the superiority of one of the methods can not be asserted according to the available evidence. Therefore, more studies are needed in order to continue this line of research.