Extubation failure: an outcome to be avoided.
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.
Department of Medicine, Caritas-St Elizabeth's Medical Center, and Professor of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA. scott.epstein@tufts.edu
Scott K
SK
Epstein
D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D015300:Ventilator Weaning / Q000009:adverse effects*