Methods In this retrospective case note study we looked at the outcome of each extubation between 1st October 2013 and 30th September 2014. We included all patients >18 years of age invasively ventilated for >48 hours. We excluded patients proceeding directly to tracheostomy or extubated for withdrawal of care. Failed extubation was defined as the need for reintubation within 5 days of planned ...

Extubation failure is an outcome of increasing importance but nearly all studies have been conducted in academic settings. The article by Seymour and colleagues demonstrates that extubation failure is an outcome to be avoided in the community hospital setting as well. Patients failing extubation experience longer lengths of stay, experience higher intensive care unit mortality, and incur greate...

BACKGROUND The purpose of the study was to analyze the risk factors for failed extubation in subjects submitted to infratentorial craniotomy. MATERIAL AND METHODS Patients aged over 18 years who received infratentorial craniotomy for brain tumor resection were consecutively included in this study. Perioperative variables were collected and analyzed. Univariate analyses and multiple logistic reg...

OBJECTIVE Despite the use of spontaneous breathing trial (SBT), predicting weaning success remains a major clinical challenge. Because cardiovascular dysfunction could be a major underlying mechanism of weaning failure, we evaluated the role of the levels of B-type natriuretic peptide (BNP), a marker for cardiovascular function, in patients who passed a 2-hr SBT. DESIGN, SETTING, AND PATIENTS...

OBJECTIVE A systematic review of weaning and extubation for pediatric patients on mechanical ventilation. DATA SELECTION Pediatric and adult literature, English language. STUDY SELECTION Invited review. DATA SOURCES Literature review using National Library of Medicine PubMed from January 1972 until April 2008, earlier cross-referenced article citations, the Cochrane Database of Systematic...

Copyright © 2013 International Anesthesia Research Society DOI: 10.1213/ANE.0b013e31827ab572 It is increasingly recognized that extubation of the difficult airway is a situation at risk of life-threatening complications, whereas criteria and guidelines to guide safe practices in airway management at extubation are still based on limited scientific evidence and of unproven effectiveness in impro...

BACKGROUND It remains to be clarified if the application of noninvasive positive pressure ventilation (NPPV) is effective after extubation in patients with hypoxemic respiratory failure who require the sufficient level of positive end-expiratory pressure (PEEP). This study was aimed at examining the effect and the safety of NPPV application following extubation in patients requiring moderate PE...

Safely returning intubated, mechanically ventilated patients to independent breathing requires 3 steps.1,2 First, clinicians must recognize when respiratory failure has resolved or improved enough to allow a spontaneous breathing trial (SBT). Second, a 30–120 min SBT should be used to test the patient’s ability to breathe without the ventilator.3 Third, if the SBT is successful, the physician m...

OBJECTIVE The objective of this study was to evaluate the ratio of dead space to tidal volume (VD/VT) as a predictor of extubation failure of children from mechanical ventilation. METHODS From September 2001 to January 2003 we studied a cohort consisting of all children (1 day-15 years) submitted to mechanical ventilation at a pediatric intensive care unit who were extubated and for whom pre-...