A study of more than 800 mechanically ventilated patients with acute brain injury (ABI) found that neither the type nor the length of spontaneous breathing trial (SBT) affected the likelihood of extubation failure. The post-hoc analysis included 839 patients from the ENIO study, including 396 (47.2%) with traumatic brain injury as the cause of admission. SBTs were performed using pressure support ventilation (PSV) in 430 (51.3%), T-piece in 329 (39.2%), and continuous positive airway pressure (CPAP) in 80 (9.5%), with median durations of 60 minutes for PSV and T‑piece and 120 minutes for CPAP. Extubation failure – the primary outcome – occurred in 177 patients (21.1%). Multivariable logistic regression showed no significant association between SBT modality or duration and extubation failure, and subgroup analyses of ABI etiologies yielded similar findings. With inverse probability weighting, vigorous cough remained the single reliable indicator of successful extubation, the researchers report.