STUDY OBJECTIVE Predicting patient responses to changes in ventilatory support or weaning is primarily based on bedside measure of respiratory mechanics and clinical judgement. Work of breathing (WOB) has been considered to be the best predictive factor in weaning. This study evaluated patient WOB as a predictive measure of weaning and extubation. DESIGN Blinded, descriptive evaluation of the...

INTRODUCTION The diaphragm plays a pivotal role in weaning and successful extubation. We hypothesized that ultrasonographic evaluation of the movements of the diaphragm by measuring liver/spleen displacement during spontaneous breathing trials is a good predictor for extubation outcome. PATIENTS AND METHODS The studied subjects were intubated patients receiving mechanical ventilation who were...

N Engl J Med 2014;370:e4. DOI: 10.1056/NEJMvcm1300964 Copyright © 2014 Massachusetts Medical Society. Overview Endotracheal extubation refers to the removal of an endotracheal tube from the trachea. This procedure is commonly performed in operating rooms, postanesthesia care units, and intensive care units. This review focuses on extubation of the trachea after general anesthesia and short-term...

Objective To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. Methods A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Te...

PURPOSE OF REVIEW In intubated patients, mechanical ventilation offers essential ventilatory support, while the respiratory system recovers from acute respiratory failure. Yet, invasive mechanical ventilation is associated with risks and complications that prolong the duration of mechanical ventilation and increase the risk for death. Therefore, safely weaning the patient from the ventilator as...

BACKGROUND Extubation failure is associated with increased morbidity and mortality, but cannot be safely predicted or avoided. High-flow nasal cannula (HFNC) prevents postextubation respiratory failure in low-risk patients. OBJECTIVE To demonstrate that HFNC reduces postextubation respiratory failure in high-risk non-hypercapnic patients compared with conventional oxygen. METHODS Randomized...

Early and successful extubation prevents several morbidities in preterm newborns. Several secondary non-invasive respiratory modalities exist but with their merits demerits. Given the benefits of nasal high-frequency oscillatory ventilation (nHFOV), we tried to examine whether nHFOV could reduce reintubation rates compared intermittent positive pressure (NIPPV) during post-extubation phase infa...

OBJECTIVE To investigate the association between the rapid shallow breathing index and successful extubation in patients with traumatic brain injury. METHODS This study was a prospective study conducted in patients with traumatic brain injury of both genders who underwent mechanical ventilation for at least two days and who passed a spontaneous breathing trial. The minute volume and respirato...

The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characterist...

BACKGROUND Extubation failure (EF), defined as need for re-intubation within 24-72 h, is multifactorial. Factors predicting EF in adults generally are not useful in children. OBJECTIVE To determine the factors associated with EF and to facilitate prediction of EF in mechanically ventilated infants and children less than 12 years of age. MATERIAL AND  METHODS Design Prospective cohort study....