Biomarkers during a spontaneous breathing trial to predict extubation failure

Introduction Extubation failure occurs in up to 20%, despite a successful spontaneous breathing trial (SBT). We hypothesized that serial biomarkers during an SBT could identify patients at risk. We aimed to investigate the association between serial biomarkers during an SBT and extubation failure. Methods We included adult patients ventilated ≥48 hours and undergoing an SBT in a multicenter cohort study. Primary and secondary endpoints were extubation failure (reintubation ≤7-days), and ICU mortality. Logistic regression assessed associations between log2-transformed biomarkers at SBT start and their relative change during the SBT with the endpoints. Post-hoc analyses focused on extubation failure due to non-airway failure (exclusion of extubation failure due to airway problems). Results 150 patients were included (mean age 63±13 years, 61% male). None of the biomarkers (start SBT and relative change (not presented)) were associated with extubation failure (n=33, 22%, Figure 1). However, Hs-Troponin-T (Hs-TnT), CKMB, Cystatin-C measured at start of the SBT were associated with extubation failure due to non-airway failure (n=23), and NT-proBNP, Hs-TnT, Galectin-3, and Cystatin-C with ICU mortality. Conclusions Although biomarkers were not associated with extubation failure, we found associations of cardiac and renal biomarkers with non-airway failure (Hs-TnT, CKMB, Cystatin-C) and ICU mortality (NT-proBNP, Hs-TnT, Galectin-3, Cystatin-C). erjor;12/suppl_17/135/F1 F1 F1