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Risk factors and outcomes for airway failure vs non-airway failure in the intensive care unit: A multicenter observational study of 1514 extubation procedures

Critical Care Sep 27, 2018

Jaber S, et al. - Given the risk of extubation failure, including the inability to breathe without a tracheal tube (airway failure) or without mechanical ventilation (non-airway failure) among patients liberated from invasive mechanical ventilation, researchers investigated the respective risk factors for airway failure and non-airway failure following extubation. Among cases of intensive care unit extubation failure, airway failure and non-airway failure were differentiated for the first time in a large study. As per findings, risk factors for extubation failure were either common to airway failure and non-airway failure (intubation for coma, intubation for acute respiratory failure, absence of strong cough) or specific to each specific mechanism (airway failure: female sex, length of ventilation > 7 days, copious secretions; non-airway failure: non-obese status, sequential organ failure assessment score ≥ 8). The researchers suggested that an individualized strategy separating airway failure from non-airway failure might allow clinicians to enhance patient management before liberation from invasive mechanical ventilation.

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