OBJECTIVE: To compare mechanical ventilation weaning based on a protocol using the spontaneous breathing trial against mechanical ventilation weaning without a standardized protocol in heart patients. METHODS: Prospective, open, randomized study. In 2006, 36 patients undergoing mechanical ventilation for over 24 hours were randomized into two groups: control group -- eighteen patients whose mechanical ventilation weaning was performed according to the different procedures adopted by the multidisciplinary team; and experimental group -- eighteen patients weaned according to previously established protocol. RESULTS: Control group patients started the weaning process sooner than experimental group patients (74.7 +/- 14.7 hours versus 185.7 +/- 22.9 hours, p = 0.0004). However, after the experimental group patients were ready for weaning, the extubation was carried out more rapidly than in the control group (149.1 +/- 3.6 min versus 4,179.1 +/- 927.8 min, p < 0.0001) with significantly lower reintubation rates (16.7% versus 66.7%, p = 0.005). CONCLUSION: The use of a specific protocol based on the spontaneous breathing trial for mechanical ventilation weaning in heart patients had better outcomes than weaning carried out without a standardized protocol, with shorter weaning times and lower reintubation rates.

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