OBJECTIVE To evaluate the performance of an extubation readiness test based on a spontaneous breathing trial using pressure support. DESIGN Retrospective chart review. SETTING Pediatric intensive care unit. PATIENTS All infants and children admitted to the pediatric intensive care unit requiring intubation from July 2007 to December 2008 were eligible for this study. INTERVENTIONS Routi...

Background Unplanned extubations can result in serious complications. Objectives To determine characteristics of patients and nurses and risk factors that affect extubations. Methods A retrospective exploratory design was used. Ramsay Sedation Scale scores, need for reintubation, time between intubation and extubation, use of sedation and analgesia in the preceding 48 hours, and use of restrain...

BACKGROUND The ideal timing for extubation of patients with myasthenic crisis (MC) and the factors that influence extubation outcome are not well established. OBJECTIVES To assess the risk of extubation failure in MC and to identify predictors of extubation failure. DESIGN We reviewed consecutive episodes of MC treated with endotracheal intubation from January 1, 1987, through December 31, ...

The incidence of myocardial ischaemia during tracheal intubation and extubation was compared using ambulatory ECG monitoring in 60 patients undergoing a variety of different surgical operations. Seven patients had myocardial ischaemia after tracheal intubation and seven patients during tracheal extubation. The patients who developed myocardial ischaemia during tracheal extubation had significan...

The mode of ventilation used during awake extubation has not previously been studied. We conducted a randomised controlled trial comparing spontaneous respiration, intermittent positive pressure ventilation, and pressure support ventilation (each n = 13) for incidence and severity of peri-extubation complications following routine elective surgery. We found the severity of peri-extubation cough...

BACKGROUND Approaches to respiratory care of patients needing prolonged mechanical ventilation (PMV) might be varied. In this study we assessed the predictive value of usual variables for extubation outcome in PMV patients. METHODS From 2005 to 2007, intubated patients who were admitted to the intermediate respiratory care unit, had been on mechanical ventilation for ≥ 21 days at the time of ...

OBJECTIVE To evaluate the association between extubation failure and outcomes (clinical and functional) in patients with traumatic brain injury (TBI). METHODS A prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after ext...

INTRODUCTION Early tracheal extubation is a common goal after cardiac surgery. Our study aims to examine whether timing of tracheal extubation predicts improved postoperative outcomes and late survival after cardiac surgery. We also evaluated the optimal timing of extubation and its association with better postoperative outcomes. METHODS Between 2002 and 2006, 1164 patients underwent early tr...

Objective: The purpose of this study was to update the state of knowledge on unplanned extubations (UEs) in neonatal intensive care units (NICUs). This review focuses on the following topics: incidence, risk factors, reintubation after UE, outcomes, and prevention. Material and Methods: Electronic databases were searched for relevant publications from January 1, 1950 through January 30, 2012 on...

The objective of this study was to assess the impact of fiber-optic laryngoscopy (FOL) on the weaning process from mechanical ventilation in critically ill patients with a positive cuff leak test (CLT) as compared with the current recommended strategy based on corticosteroids.In this prospective observational pilot study conducted over a 1-year period in a 15-bed ICU, CLT was systematically per...