Brain-injured Patients Extubation Readiness Study

Prior treatment

• Significant chest trauma (more than 2 broken ribs / broken sternum / with an indication of open thoracic surgery)
• Surgery planned within 7 days
• Tracheotomy or previous extubation outside of the protocol
• Previous compromised upper airway permeability

Other illness

• Admission for status epilepticus or central nervous system infection
• Uncontrolled status epilepticus or uncontrolled central nervous system infection
• Chronic respiratory failure defined as ambulatory oxygen therapy or pressure support ventilation and/or proven COPD and/or ambulatory non-invasive CPAP therapy for sleep apnoea syndrome

Other

• Posterior cranial fossa lesion
• Spinal cord injury (tetraplegia or paraplegia)
• Care limitation plan
• More than 3 failed spontaneous breathing trials
• Pregnant or breastfeeding woman
• Adult under the protection of the law or without social assurance system
• Inclusion in another clinical study about mechanical ventilation or weaning

• Acute cerebral lesion with a Glasgow Coma Scale \<13 needing admission in ICU and mechanical ventilation with tracheal intubation for neurological cause : cerebrovascular stroke either ischemic or hemorrhagic including aneurysmal subarachnoid hemorrhage, traumatic brain injury, anoxo ischemic encephalopathy after cardiac arrest or brain tumour
• Mechanical ventilation more than 48 hours
• 18 to 75 years old
• Neurological stability with no intracranial hypertension with minimal sedation
• Glasgow Coma Scale motor response \< 6
• Spontaneous breathing trial succeeded
• First extubation attempt