🫁 Spontaneous Breathing Trial Screening (SBT Readiness)
UseUse to check readiness criteria before an SBT and to interpret pass/fail to guide extubation.
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SourceATS/ACCP liberation guidelines. Am J Respir Crit Care Med 2017.
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
Daily readiness screening plus an SBT shortens ventilation duration compared with gradual weaning (original synthesis · not guideline verbatim).
When to use
Use to check readiness criteria before an SBT and to interpret pass/fail to guide extubation.
How it works
Assess readiness (resolving cause, adequate oxygenation on low support, hemodynamic stability, intact airway protection); perform SBT 30–120 min on minimal support or T-piece; pass → consider extubation; fail → resume support and address the cause.
Key points
- Daily readiness screening plus an SBT shortens ventilation duration compared with gradual weaning (original synthesis · not guideline verbatim).
- Pair the SBT with a spontaneous awakening trial (sedation interruption) for the greatest benefit.
- A passed SBT does not guarantee extubation success — also assess airway patency (cuff leak) and secretion burden.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Cause of respiratory failure improved/controlled | No |
|---|---|
| Adequate oxygenation (PaO₂/FiO₂ ≥ 150, FiO₂ ≤ 0.5, PEEP ≤ 5–8, SpO₂ ≥ 90%) | No |
| Hemodynamically stable (no/low-dose vasopressors, no active myocardial ischemia) | No |
| pH ≥ 7.25 | No |
| Can trigger spontaneous breaths, arousable | No |
→SBT readinessNot met
- Determination：Not met: cause not controlled, oxygenation not adequate, hemodynamically unstable, pH < 7.25, no spontaneous breathing/not arousable
- Management direction：Continue optimizing (treat the primary disease, adjust sedation/volume/internal milieu), re-screen after correction; can pair with a daily spontaneous awakening trial (SAT)
- Note：SBT readiness is the first step in weaning: cause improved + adequate oxygenation + hemodynamic stability + pH ≥ 7.25 + able to breathe spontaneously. Passing an SBT is key evidence for extubation, but airway protection (cough strength, secretions, airway patency) must also be assessed
| Cause of respiratory failure improved/controlled | Yes |
|---|---|
| Adequate oxygenation (PaO₂/FiO₂ ≥ 150, FiO₂ ≤ 0.5, PEEP ≤ 5–8, SpO₂ ≥ 90%) | Yes |
| Hemodynamically stable (no/low-dose vasopressors, no active myocardial ischemia) | Yes |
| pH ≥ 7.25 | Yes |
| Can trigger spontaneous breaths, arousable | Yes |
→SBT readinessMet (SBT can proceed)
- Determination：All readiness criteria met → may start a spontaneous breathing trial
- Management direction：Perform SBT: low support (PSV 5–8/PEEP ≤ 5 or T-piece) for 30–120 min; pass criteria = tolerance, RR < 35, SpO₂ ≥ 90%, no distress/diaphoresis/arrhythmia or hemodynamic deterioration; may combine with RSBI < 105. If passed with good airway protection and manageable secretions → extubate
- Note：SBT readiness is the first step in weaning: cause improved + adequate oxygenation + hemodynamic stability + pH ≥ 7.25 + able to breathe spontaneously. Passing an SBT is key evidence for extubation, but airway protection (cough strength, secretions, airway patency) must also be assessed
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Spontaneous Breathing Trial Screening (SBT Readiness)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Spontaneous Breathing Trial Screening (SBT Readiness) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Spontaneous Breathing Trial Screening (SBT Readiness) calculated in practice? Can you show a worked example?
- Inputs: Cause of respiratory failure improved/controlled No, Adequate oxygenation (PaO₂/FiO₂ ≥ 150, FiO₂ ≤ 0.5, PEEP ≤ 5–8, SpO₂ ≥ 90%) No, Hemodynamically stable (no/low-dose vasopressors, no active myocardial ischemia) No, pH ≥ 7.25 No, Can trigger spontaneous breaths, arousable No → Result: SBT readiness Not met（Determination: Not met: cause not controlled, oxygenation not adequate, hemodynamically unstable, pH < 7.25, no spontaneous breathing/not arousable, Management direction: Continue optimizing (treat the primary disease, adjust sedation/volume/internal milieu), re-screen after correction; can pair with a daily spontaneous awakening trial (SAT), Note: SBT readiness is the first step in weaning: cause improved + adequate oxygenation + hemodynamic stability + pH ≥ 7.25 + able to breathe spontaneously. Passing an SBT is key evidence for extubation, but airway protection (cough strength, secretions, airway patency) must also be assessed） Inputs: Cause of respiratory failure improved/controlled Yes, Adequate oxygenation (PaO₂/FiO₂ ≥ 150, FiO₂ ≤ 0.5, PEEP ≤ 5–8, SpO₂ ≥ 90%) Yes, Hemodynamically stable (no/low-dose vasopressors, no active myocardial ischemia) Yes, pH ≥ 7.25 Yes, Can trigger spontaneous breaths, arousable Yes → Result: SBT readiness Met (SBT can proceed)（Determination: All readiness criteria met → may start a spontaneous breathing trial, Management direction: Perform SBT: low support (PSV 5–8/PEEP ≤ 5 or T-piece) for 30–120 min; pass criteria = tolerance, RR < 35, SpO₂ ≥ 90%, no distress/diaphoresis/arrhythmia or hemodynamic deterioration; may combine with RSBI < 105. If passed with good airway protection and manageable secretions → extubate, Note: SBT readiness is the first step in weaning: cause improved + adequate oxygenation + hemodynamic stability + pH ≥ 7.25 + able to breathe spontaneously. Passing an SBT is key evidence for extubation, but airway protection (cough strength, secretions, airway patency) must also be assessed）