a study published in the previous issue of Critical Care, Gonçalves and colleagues [1] observed a 33% reduction in re-intubation rate in the study group, due to eff ective management of bronchial secretions. Current evidence favors early implementation of noninvasive mechanical ventilation (NIV) in the post-extubation period to reduce re-intubation, especially in patients with hypercapnic respi...

OBJECTIVE To develop additional criteria to predict for successful extubation of very-low-birth-weight infants recovering from respiratory distress syndrome. DESIGN Prospective study. SETTING Neonatal intensive care unit at a university teaching hospital. INTERVENTIONS Infants ready for extubation according to clinical, ventilatory and blood gas criteria were studied. Before extubation, t...

BACKGROUND Remifentanil and dexmedetomidine are well known to suppress airway reflexes during airway procedures. Smooth tracheal extubation is important after otologic surgery. The purpose of this study is to compare the effectiveness of dexmedetomidine or remifentanil infusion for producing smooth tracheal extubation in deeply anesthetized patients after otologic surgery. METHODS Seventy-fou...

Methods Prospective collected database was conducted from December 2014 to April 2015. Weak cough was defined by peak expiratory flow (PEF) < 60 L/min. The PEF was measured with Cosmed Pony Graphic spirometer v.4.0 S-CZ before extubation, for the patients mechanically ventilated >24 h, who passed successfully SBT at least of 30 min of pressure support 5-8 cmH2O, CPAP, or T-T. The patients were ...

BACKGROUND Economics has caused the trend of early tracheal extubation after cardiac surgery, yet no prospective randomized study has directly validated that early tracheal extubation anesthetic management decreases costs when compared with late extubation after cardiac surgery. METHODS This prospective, randomized, controlled clinical trial was designed to evaluate the cost savings of early ...

Background: Tracheal intubation is a life-saving measure in patients poisoned acutely with opioid, and when naloxone treatment is inadequate. This study determined the risk factors for early unplanned extubation in these patients and evaluated the effects on the clinical outcomes. Methods: At a poisoning center in Tehran, Iran, 165 opioid overdose patients who were admitted to the intensive ca...

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...

Background Extubation is a more challenging medical practice than intubation, and countermeasures against it are similar to those described in the Difficult Intubation Guidelines, but problems cannot be overcome by completely the same methods. We predicted difficult extubation in a pediatric patient with left recurrent laryngeal nerve paralysis and devised an extubation method. Case presentat...

BACKGROUND Extubation is associated with the risk of complications such as accumulated secretion above the endotracheal tube cuff, eventual atelectasia following a reduction in pulmonary volumes because of a lack of physiological positive end expiratory pressure, and intra-tracheal suction. In order to reduce these complications, and, based on basic physiological principles, a new practical ext...

Patients undergoing neurosurgery are predisposed to a variety of complications related to mechanical ventilation (MV). There is an increased incidence of extubation failure, pneumonia, and prolonged MV among such patients. The aim of the present study was to assess the influence of extubation failure and prolonged MV on the following variables: postoperative pulmonary complications (PPC), morta...