117. Pulm PEEPs Pearls: Spontaneous Breathing Trials

This week’s Pulm PEEPs Pearls episode is all about spontaneous breathing trials (SBTs). SBTs are a standard part of the daily practice in the intensive care unit, but the exact methods vary across ICUs and institutions. Listen in to hear about the most common methods of SBTs, the physiology of each method, and what the evidence says.

Contributors

This episode was prepared with research by Pulm PEEPs Associate Editor George Doumat.

Dustin Latimer, another Pulm PEEPs Associate Editor, assisted with audio and video editing.

Key Learning Points

What an SBT is really testing

An SBT is a stress test for post-extubation work of breathing, not just a ventilator check.

The goal is to balance sensitivity and specificity:

Too hard → unnecessary failures and delayed extubation

Too easy → false positives and higher risk of reintubation

Common SBT modalities and how they compare

T-piece