Clinical Research Directory

Inclusion Criteria: * Adult patient * hospitalized in the intensive care unit * receiving invasive mechanical ventilation for 24 hours or more. * who has failed at least one spontaneous breathing trial Exclusion Criteria: * Patient already intubated during current ICU stay (including transfer from another ICU unit), with successful extubation during stay. * Tracheostomized patient or patient with a short-term tracheostomy project. * Patients with chronic neuromuscular pathologies (myopathy, amyotrophic lateral sclerosis, multi-system atrophy, non-exhaustive list). * Patient no longer eligible for SBT at time of inclusion (hemodynamic, neurological or respiratory criterion) * Psychiatric pathology identified in the medical record, diagnosed by a psychiatrist and for which medication is prescribed (bipolar disorder, schizophrenia, anxiety-depressive disorder, non-exhaustive list). * Recent brain injury, within \< 3 months (stroke, cardiopulmonary arrest with neurological prognosis, non-exhaustive list) objectivated by medical imagery. * Cognitive impairment or delirium associated with resuscitation, identified by a positive CAM-ICU (Confusion Assessment Method for the Intensive Care Unit) test (dynamic parameter). * Ocular Glasgow score lower than 4/4 and motor response lower than response to simple commands. * Delirium tremens with Cushman score \> 7 (dynamic parameter). * Language barrier, patient who does not use French in everyday life. * Deaf or hearing-impaired patients. * Re-sedated patient following the failed SBT the day before inclusion. * Pregnant, parturient or breastfeeding women, objectified by a negative pregnancy test in women of childbearing age. * Patient for whom a limitation of therapeutics has been decided, including the absence of a re-intubation project. * Patient whose consent cannot be obtained (directly or in front of a relative or witness). * Patient already included in the same study or in another study sharing the same primary outcome. * Patient deprived of liberty by judicial or administrative decision. * Patient of legal age under legal protection (guardianship, curators). * Patient not affiliated to a social security system or beneficiary of a similar system. * Patient participating in another interventional research study with an exclusion period still in effect at pre-inclusion.