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. 2013 Dec 9;2013(12):CD004127. doi: 10.1002/14651858.CD004127.pub3

Girault 1999.

Methods RCT
 (n = 33)
Opaque envelopes
Participants Participants with acute‐on‐chronic respiratory failure (COPD, restrictive, mixed) failing a two‐hour T‐piece trial after invasive mechanical ventilation for at least 48 hours. Participants were identified through daily screening
Interventions Participants were randomly assigned to receive invasive pressure support or NPPV delivered in flow or pressure mode. NPPV was delivered intermittently following extubation, separated by periods of SB of increasing duration. Invasive PS was titrated by 3 to 5 cm H2O according to tolerance. Discontinuation of support followed successful completion of two periods of observation during SB (NPPV) or during PS weaning with optional SBTs (IPPV). Extubation was performed when PS was less than 8 cm H2O in the IPPV group
Outcomes 1. 90‐day mortality
 2. Hospital mortality
 3. Successful weaning
 4. VAP
 5. Duration of MV related to weaning
 6. Duration of ETMV
 7. Mean daily period of support
 8. ICU LOS
 9. Hospital LOS
 10. Adverse events
 11. Reintubation
 12. Tracheostomy
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not specified. Randomization and introduction of the weaning procedure IPSV or NPPV were done during the 24 hours after the two‐hour SBT
Allocation concealment (selection bias) Unclear risk Opaque envelopes
Incomplete outcome data (attrition bias) 
 All outcomes Low risk None missing
Selective reporting (reporting bias) Low risk Protocol not available. Published manuscript reports on prespecified outcomes