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Commentary

Extubation failure: an outcome to be avoided

Scott K Epstein

Author Affiliations

Vice Chairman for Educational Affairs, Department of Medicine, Caritas-St Elizabeth's Medical Center, and Professor of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA

Critical Care 2004, 8:310-312  doi:10.1186/cc2927


See related research article, http://ccforum.com/content/8/5/R322

Published: 10 August 2004

Abstract

Extubation failure is an outcome of increasing importance but nearly all studies have been conducted in academic settings. The article by Seymour and colleagues demonstrates that extubation failure is an outcome to be avoided in the community hospital setting as well. Patients failing extubation experience longer lengths of stay, experience higher intensive care unit mortality, and incur greater hospital costs. Investigators have identified tools for predicting extubated patients at highest risk for reintubation. The predictors focus on detecting upper airway obstruction, inadequate cough, excess respiratory secretions, and abnormal mental status. Systematic application of these predictors has the potential to improve outcome.

Keywords:
extubation failure; intensive care unit mortality; mechanical ventilation; reintubation