In this episode, we break down spontaneous breathing trials (SBT) and extubation criteria used in the ICU to evaluate ventilator weaning and readiness for extubation. Learn how spontaneous breathing trials are performed, how to calculate and interpret the rapid shallow breathing index (RSBI), and how pressure support, CPAP, and T-piece trials compare in assessing patient breathing during mechanical ventilation. We review clinical evidence, ventilator management strategies, and the physiologic principles behind each spontaneous breathing trial method. This episode also includes practice questions to reinforce key mechanical ventilation concepts for respiratory therapists, ICU clinicians, nurses, and medical learners. This episode is ideal for healthcare professionals learning mechanical ventilation, respiratory therapy, ventilator weaning, and critical care medicine. 📚 Download the PDF study guide for this video: 👉 https://www.patreon.com/c/WhiteBoardMedicine Patreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians. Episode Timestamps 00:00 – 04:39 Introduction and what is a spontaneous breathing trial (SBT) 04:40 – 12:24 When and how to perform a spontaneous breathing trial 12:25 – 20:22 RSBI, passing SBT, evidence and guidelines 20:23 – 22:57 Comparing pressure support, CPAP, and T-piece trials 22:58 – 25:49 Practice questions (Part 1) 25:50 – 36:35 Deep dive: Pressure support trial 36:36 – 40:42 Deep dive: CPAP trial 40:43 – 46:54 Deep dive: T-piece trial 46:55 – 50:25 Practice questions (Part 2) Link to YouTube video:https://www.youtube.com/watch?v=Fldrxt05Ks4 Disclaimer This content is provided for educational purposes only and is intended for healthcare professionals. It is not medical advice and should not be used as a substitute for clinical judgment, professional training, or institutional protocols. The information presented reflects general educational discussion and does not represent the official views, policies, or positions of any hospitals, healthcare organizations, or affiliated institutions. Clinical decisions should always be made in accordance with local guidelines, institutional policies, and appropriate supervision by qualified medical professionals.

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