Direct Extubation Versus Extubation After a Spontaneous Breathing Trial in Patients at Low Risk of Extubation Failure

Inclusion Criteria: * Age older than 18 years and \< 65 years old * Nasal or oral intubation longer than 24 hours and less than 4 days * Satisfaction to each following weaning readiness criteria: 1. Respiratory rate \< 35 cycles per minute 2. SpO2 \>90% with FiO2\<40% and PEEP\<8 cmH2O 3. RASS score between -2 and +2 with low level or no sedatives 4. No need or low doses of vasopressors 5. Adequate cough * Inform consent by patient or legal representative or the close relative or emergency inclusion procedure. Exclusion Criteria: * Risk factor for extubation failure as defined by any of the following criteria: * Chronic cardiac disease (left ejection fraction below 45%, documented history of cardiogenic pulmonary edema, permanent atrial fibrillation). * Chronic respiratory disease (severe COPD, documented restricted lung disease or obesity-hypoventilation syndrome) * Body mass index \> 30 kg/m2 * Airway patency problems, including high risk of developing laryngeal edema, inability to deal with respiratory secretions, brain injury, documented swallowing disorders * Tracheostomy * Underlying chronic neuromuscular disease * Do not resuscitate orders * Pregnant or lacting woman * Patient under guardianship * Patient without healthcare insurance * Refusal to participate and sign the written consent * Patients with traumatic brain injury * Post surgery patients * Patients included in another interventional trial that may have an impact on the evaluation criteria of the present study * Patient under AME