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 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...

This prospective, case-controlled observational study assessed whether an evidence-based extubation checklist would increase anesthesia providers' documentation of standardized extubation criteria and reduce the occurrence of preventable extubation failures in the early postoperative period. The sample consisted of 622 ASA Physical Status I to IV patients, aged 10 to 100 years but primarily adu...

Tracheal extubation is a high-risk phase of anaesthesia. The majority of problems that occur during extubation and emergence are of a minor nature, but a small and significant number may result in injury or death. The need for a strategy incorporating extubation is mentioned in several international airway management guidelines, but the subject is not discussed in detail, and the emphasis has b...

Safe liberation from mechanical ventilation remains a challenge for the critical care physician. Undue prolongation of mechanical ventilation or extubation failure followed by re-intubation is associated with negative outcome. Recent clinical practice guidelines suggest using pressure augmentation during a spontaneous breathing trial (SBT), which would result in more successful SBTs and higher ...