Clinical Research Directory

Inclusion Criteria : all patients ≥ 18 y.o admitted to the ICU, under invasive mechanical ventilation for more then 24 hours and fullfilling the following weaning criteria : * Resolution or improvement of the condition that led to intubation, as judged by the clinician in charge of the patient. * Hemodynamic stability, defined as systolic blood pressure between 90 and 160 mmHg, heart rate less than 140 beats/min, without or with low doses of vasopressors. * Glasgow score of 13 or greater and Richmond Agitation-Sedation Scale (RASS) score between -1 and +1. * Respiratory stability defined as: oxygen saturation \> 90% with inspired oxygen fraction ≤ 0.5 and PEEP ≤ 8 cmH2O, respiratory rate \< 35/min, spontaneous tidal volume \> 5 mL/kg, and peak inspiratory pressure ≤ 15 cmH2O. * Few secretions (\< 3 aspirations in the past 8 hours). * Effective cough. * Negative leak test (\>100 mL or \>10%). * No surgery planned within 72 hours. * Patients with a social security plan. Exclusion Criteria: * Acute cerebral pathology requiring admission to intensive care and/or mechanical ventilation with tracheal intubation for neurological reasons (Glasgow score \<13 at the time of intubation or CT scan abnormality): hemorrhagic stroke without or with vascular malformation (aneurysm, arterio-venous malformation...), ischemic stroke, head trauma, cerebral anoxo-ischemia after cardiac arrest. * Tetraplegic or paraplegic patients with lesion level higher than D8. * Peripheral neuromuscular pathology (underlying myopathy or myasthenia). * ICU's Neuromyopathy. * Tracheostomy. * Patients with a decision of non-reintubation or terminal intubation. * Pregnant or lactating women. * Patients already included in this study. * Patients under guardianship, curatorship or safeguard of justice.