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...

Extubation failure, defined as the need for reinstitution of ventilatory support within 24 to 72 hours of planned endotracheal tube removal, occurs in 2 to 25% of extubated patients. The pathophysiologic causes of extubation failure include an imbalance between respiratory muscle capacity and work of breathing, upper airway obstruction, excess respiratory secretions, inadequate cough, encephalo...

Background. Automatic tube compensation (ATC) has been developed to overcome the imposed work of breathing due to artificial airways during spontaneous breathing trials (SBTs). Objectives. This study aimed to assess extubation outcome after an SBT (spontaneous breathing trial) with ATC compared with pressure support ventilation (PSV) and to determine the risk factors for extubation failure. Met...

Purpose: To investigate the pulmonary outcomes of early extubation (within the first 24 hours of life) with synchronized nasal intermittent positive pressure ventilation (NIPPV) in extremely premature infants born at 25–26 weeks’ gestation. Methods: Medical records of extremely premature infants (gestational age: 25–26 weeks) born and admitted to the Keimyung University Dongsan Medical Center b...

OBJECTIVE A systematic review of weaning and extubation for pediatric patients on mechanical ventilation. DATA SELECTION Pediatric and adult literature, English language. STUDY SELECTION Invited review. DATA SOURCES Literature review using National Library of Medicine PubMed from January 1972 until April 2008, earlier cross-referenced article citations, the Cochrane Database of Systematic...

Results Out of 680 intubations, 73(11%) patients [46 (63%) male] had failed extubations. Average age was 60(21-88) years. Average time to re-intubation was 22.1(1-72) hours, 45(62%) being re-intubated at≤24 hours. Average time intubated was 2.2 days with 3 patients intubated for >7 days. Fifteen(21%) patients had had no sedation within 4 hours of extubation. All others had one or more of fentan...

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...