The American College of Chest Physicians and the American Thoracic Society have recently published clinical guidelines on the management of mechanical ventilation in critically ill adult patients who are near extubation. These guidelines considered six important questions in the management of these patients. 1-3 1. Should spontaneous breathing trials be conducted with or without inspiratory pressure support? This panel suggested that spontaneous breathing trials should be conducted with

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... ory pressure support in the range of 5-8 cm of water. This approach can increase extubation success from approximately 67% to 74%. This information is based on four randomized controlled trials which included 875 patients.