背景和目的：探討面罩式〝雙氣道正壓式呼吸器〞對於T 型管兩小時試驗，拔管失敗之影響。方法：選擇100 位插管之呼吸器病患，當符合每日篩選指標(daily screen)時，接受2 小時T 型管自發性呼吸試驗，成功者給予拔除人工氣管插管，隨機使用氧氣面罩(O2 mask) 或面罩式雙氣道正壓式呼吸器(NIV)。結果：100 位呼吸器病患中有85 位(85%) 拔管成功，15 位拔管失敗(15%)，NIV 組，拔管失敗率是18% (9/50 位失敗)；而O2 mask 的群組是12% (6/50 位失敗)，在統計學上無顯著差異，15 位拔管失敗患者有6 位重插管，其中有2 位死亡，可讓拔管失敗的病患之再插管率降至(6/15，40%)。結論：通過T 型管兩小時自發性呼吸測試之病患，拔管後預防性的使用非侵入性呼吸器無法有效降低拔管失敗率。

Background and Purpose: Mechanical ventilation can save the life of a patientwith acuterespiratory failure, but efforts should focus on weaning the patient from mechanical ventilation asrapidly as possible after recovery. Because complications with extubation failure are high and mayincrease morbidity and mortality, prevention of extubation failure is critically important. Weapplied BiPAP, a noninvasive mode of pressure support ventilation, in an attempt to decrease therate of reintubation. Methods: We prospectively enrolled 100 patients who had undergoneextubation by T-piece weaning for 2 h. After extubation, patients were randomly divided into 2groups with anO2mask ormask-BiPAP. Results: Extubation was successful in 85 patients (85%)and failed in 15 patients (15%). The extubation failure ratewas 18%in the mask-BiPAP study groupand 12% in the O2-mask control group, a difference that was not statistically significant. Amongthe 15 patients in whom extubation failed, 6 required reintubation and 2 died (2/15; 13.33%), butthe reintubation rate (6/15; 40%) could have been reduced. Conclusion: Noninvasive ventilationdid not affect the outcome of extubation after the 2-h T-piece trial.