title: Out-of-bed extubation: a feasibility study.
abstract: OBJECTIVE
  In clinical intensive care practice, weaning from mechanical ventilation is accompanied by concurrent early patient mobilization. The aim of this study was to compare the success of extubation performed with patients seated in an armchair compared to extubation with patients in a supine position.
  
  
  METHODS
  A retrospective study, observational and non-randomized was conducted in a mixed-gender, 23-bed intensive care unit. The primary study outcome was success of extubation, which was defined as the patient tolerating the removal of the endotracheal tube for at least 48 hours. The differences between the study groups were assessed using Student's t-test and chi-squared analysis.
  
  
  RESULTS
  Ninety-one patients were included from December 2010 and June 2011. The study population had a mean age of 71 years ± 12 months, a mean APACHE II score of 21±7.6, and a mean length of mechanical ventilation of 2.6±2 days. Extubation was performed in 33 patients who were seated in an armchair (36%) and in 58 patients in a supine position (64%). There were no significant differences in age, mean APACHE II score or length of mechanical ventilation between the two groups, and a similar extubation success rate was observed (82%, seated group versus 85%, supine group, p>0.05). Furthermore, no significant differences were found between the two groups in terms of post-extubation distress, need for tracheostomy, duration of mechanical ventilation weaning, or intensive care unit stay.
  
  
  CONCLUSIONS
  Our results suggest that the clinical outcomes of patients extubated in a seated position are similar to those of patients extubated in a supine position. This new practice of seated extubation was not associated with adverse events and allowed extubation to occur simultaneously with early mobilization.
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Felippe Leopoldo
authors.initials: FL
authors.lastname: Dexheimer Neto
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Patrini Silveira
authors.initials: PS
authors.lastname: Vesz
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Rafael Viegas
authors.initials: RV
authors.lastname: Cremonese
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Clarissa Garcia Soares
authors.initials: CG
authors.lastname: Leães
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Ana Carolina Tabajara
authors.initials: AC
authors.lastname: Raupp
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Cristiano dos Santos
authors.initials: Cdos S
authors.lastname: Rodrigues
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Juliana Mara Stormovski
authors.initials: JM
authors.lastname: de Andrade
authors.affiliation: Unidade de Terapia Intensiva, Hospital Ernesto Dornelles, Porto Alegre, RS, Brasil.
authors.forename: Raquel da Silva
authors.initials: Rda S
authors.lastname: Townsend
authors.affiliation: Unidade de Terapia Intensiva, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Juçara Gasparetto
authors.initials: JG
authors.lastname: Maccari
authors.affiliation: Unidade de Terapia Intensiva, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Cassiano
authors.initials: C
authors.lastname: Teixeira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation / Q000379:methods*; D003422:Critical Care / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods*