Clinical Research Directory

Inclusion Criteria: 1\. Patients had undergone intubation and mechanical ventilation for more than 24 hours prior to the first spontaneous breathing trial. 2\. Adult patients aged ≥ 18 years. 3. BMI ≥ 25 kg/m². 4. Meeting all the Inter national Consensus Conference on weaning criteria: 1. Stable vital signs: heart rate \< 140 beats/min, systolic blood pressure: 90-160 mmHg, and no use of vasopressors or use of minimal doses (\<0.2 µg/kg per min). 2. Respiratory rate ≤ 35 breaths/min. 3. Adequate oxygenation, defined as either SpO2 \> 90% with FiO2 ≤ 0.4, or PaO2/FiO2 \> 150 mmHg with positive end-expiratory pressure (PEEP) ≤ 8 cmH2O. 4. Adequate cough strength (MIP \< -20 cmH2O). 5. An awake state, defined as a score of Richmond Agitation-Sedation Scale between +1 and -2, or Glasgow Coma Scale \> 8. 6. No continuous sedation. 5. Informed consent provided by the patient or their relatives. Exclusion Criteria: 1. Patients with tracheostomy. 2. Patients who had been admitted for traumatic brain injury. 3. Patients who had preexisting peripheral neuromuscular disease (underlying myopathy or myasthenia gravis). 4. Patients who had a do-not-reintubate order at the time of the initial spontaneous breathing trial were excluded 5. Patients who have already undergone a first spontaneous breathing trial. 6. Patients who had undergone extubation without an SBT 7. Protected populations: pregnant or breastfeeding women, individuals under guardianship, or those under legal protection. 8. Patients who refused to participate during the study.