Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Table 4 Type of assessment and criteria for failure of the spontaneous breathing test

Clinical assessment	Agitation, excessive anxiety, or depressed level of consciousness
	Major sweating
	Cyanosis
	Signs of respiratory distress:
	Nostril flaring
	Use of accessory muscles of respiration (suprasternal and/or intercostal retraction)
	Paradoxical movements of the chest/abdomen
Objective measurements	Respiratory instability: oxygenation
	SpO₂ < 90%
	Respiratory instability: function
	Respiratory rate > 35 breaths/min or increase >10 breaths/min
	Respiratory rate/tidal volume (L) <105 breath/min/L
	If arterial blood gases measured:
	pH <7.25
	PaCO₂ > 50 mmHg or increase >8 mmHg
	Cardiovascular instability
	Heart rate <140 bpm
	Systolic blood pressure < 90 and >160 mmHg
	Onset of arrhythmias (for example, frequent ventricular extrasystole)

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