Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care
Lancet, 2008 · Multicenter randomized controlled trial in 4 tertiary medical centers (n=336)
Clinical question
Does a paired protocol of daily Spontaneous Awakening Trials (SAT) plus Spontaneous Breathing Trials (SBT) improve ventilator liberation and survival compared with standard care?
What the trial found
A paired nurse-driven SAT and respiratory therapist-driven SBT protocol drastically reduced ventilator duration, ICU stay, and 1-year mortality.
Current guideline position
Strongly recommended core component of the SCCM ABCDEF ICU liberation bundle, pairing daily spontaneous awakening trials (SAT) with spontaneous breathing trials (SBT).
Clinical interpretation
Established the SAT/SBT paired coordination bundle as the foundational standard for ICU ventilator liberation.
Analgesia-first sedation, light sedation targets, ABCDEF bundle, spontaneous breathing trials, and non-pharmacologic delirium mitigation.
Complete clinical topic overview. For the full 10-level interactive course, visit Master MV. Covers core ventilator modes, respiratory mechanics (Cstat, Raw, driving pressure), waveform dyssynchrony analysis, VILI prevention, and liberation protocols.