Early Prediction of Extubation Failure in Severe Pneumonia: A Retrospective Cohort Study

Abstract

Background: Severe pneumonia is one of the most common causes for invasive mechanical ventilation (IMV), and the rate of extubation failure remains as high as 30%. Early identification of severe pneumonia patients with high risk of extubation failure is of great clinical importance. Methods: From April 2014 to December 2015, medical records of the patients with severe pneumonia upon admission and with IMV > 24 hours in intensive care unit were retrieved from our database. Multivariate logistic regressions were used to identify risk factors for extubation failure. Results: A total of 125 patients were included, of which 82 and 43 patients had extubation success and failure, respectively. Higher mortality (97.7% vs. 37.8%, P Conclusions: In patients with severe pneumonia, APACHE II score > 17.5, blood glucose > 9.87mmol/L, fentanyl usage > 1.135mg/d, and the need for RBC transfusion might potentially discriminate the patients with high risk of extubation failure.