Abstract
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 greater hospital costs. Investigators have identified tools for predicting extubated patients at highest risk for reintubation. The predictors focus on detecting upper airway obstruction, inadequate cough, excess respiratory secretions, and abnormal mental status. Systematic application of these predictors has the potential to improve outcome.
Highlights
The art and science of discontinuing patients from invasive mechanical ventilation continues to attract attention
Reintubation after planned extubation is associated with adverse outcomes including increased hospital mortality, prolonged hospital stay, higher costs, and greater need for tracheotomy and transfer to postacute care [2,3,4]
The adverse effects of reintubation could reflect the severity of underlying illness or could result from complications during reintubation, this has not been demonstrated with multivariate analysis [2,3,4]
Summary
The art and science of discontinuing patients from invasive mechanical ventilation continues to attract attention. Intensive care unit mortality, mechanical ventilation, reintubation Investigators have increasingly focused on the latter component, where 5–20% of extubations may fail and require reintubation.
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