Current recommendations for management of obese patients post-extubation are based on clinical experience and expert opinions. It was hypothesised that the application of noninvasive ventilation (NIV) during the first 48 h after extubation in severely obese patients would reduce post-extubation failure and avert the need for reintubation. Following protocol-driven weaning trials, 62 consecutive...

We conducted this study to find out the incidence of extubation failure (EF) in ventilated neonates and associated clinical risk factors. Eighty two ventilated neonates were followed up to 48 hours post extubation to look for EF. Twenty two babies (26.8%) had EF. The common risk factors for EF were presence of patent ductus arteriosus, post-extubation lung collapse and acquired pneumonia. The d...

Aim To determine predictors and outcomes of extubation failure in extremely preterm (EP) infants born <28 weeks' gestational age (GA). Methods Retrospective clinical audit across two tertiary-level neonatal intensive care units Melbourne, Australia. Two-hundred four EP who survived to their first from mechanical ventilation. Extubation (re-intubation) within 7 days after the extubation. Results...

BACKGROUND Non-invasive ventilation (NIV) may be useful after extubation in children. Our objective was to determine postextubation NIV characteristics and to identify risk factors of postextubation NIV failure. METHODS A prospective observational study was conducted in an 8-bed pediatric intensive care unit (PICU). Following PICU protocol, NIV was applied to patients who had been mechanicall...

HFNC therapy is increasingly used as ‘non-invasive’ respiratory support for preterm infants. A 2016 Cochrane Review found that had similar efficacy to NCPAP infants following extubation,1 but further studies were needed, particularly in extremely born <28 weeks' gestation, who are at highest risk of extubation failure. The trial by Uchiyama et al the largest randomised post-extubation infants, ...

OBJECTIVE A fast-track recovery in cardiac surgery yields many benefits, and early tracheal extubation is important as the first step. The purpose of this study is to evaluate the status of early tracheal extubation after on-pump coronary artery bypass grafting (CABG) and to find key factors for successful early tracheal extubation. METHODS From September 1996 to February 2005, isolated on-pu...

OBJECTIVE To assess the value of a spontaneous breathing trial (SBT) using a flow-inflating bag in predicting extubation success. Secondary goals were to evaluate the positive and negative predictive accuracy of a 15-min SBT. DESIGN Prospective, blinded, clinical study. SETTING Pediatric intensive care unit (ICU) of a university hospital PATIENTS Infants and children intubated for >or=24 ...

OBJECTIVE To evaluate the physiological deadspace/tidal volume ratio (VD/VT) as a predictor of extubation failure in 42 ventilated children (median age: 4.75 years). METHOD Extubation readiness was determined using the criteria proposed by the 6th International Consensus Conference on Intensive Care Medicine adapted to children. RESULTS Non-invasive ventilation (NIV) was used in four patien...

RET 2.0 DESCRIPTION/DEFINITION The decision to discontinue mechanical ventilation involves weighing the risks of prolonged mechanical ventilation against the possibility of extubation failure.1,2 This guideline will focus on the predictors that aid the decision to extubate, the procedure referred to as extubation, and the immediate postextubation interventions that may avoid potential reintubat...

BACKGROUND/AIMS Both diaphragmatic excursion and change in muscle thickening are measured using ultrasonography (US) to assess diaphragm function and mechanical ventilation weaning outcomes. However, which parameter can better predict successful extubation remains to be determined. The aim of this study was to compare the clinical utility of these two diaphragmatic parameters to predict extubat...