title: The effect of reintubation on ventilator-associated pneumonia and mortality among mechanically ventilated patients with intubation: A systematic review and meta-analysis.
abstract: OBJECTIVE
  This meta-analysis summarized the risks that reintubation impose on ventilator-associated pneumonia (VAP) and mortality.
  
  
  BACKGROUND
  Extubation failure increases the probability of poor clinical outcomes pertaining to mechanical ventilation.
  
  
  METHODS
  Literature published during a 15-year period was retrieved from PubMed, Web of Knowledge databases, the Embase (Excerpa Medica database), and the Cochrane Library. Data involving reintubation, VAP, and mortality were extracted for a meta-analysis.
  
  
  RESULTS
  Forty-one studies involving 29,923 patients were enrolled for the analysis. The summary odds ratio (OR) between VAP and reintubation was 7.57 (95% confidence interval [CI] = 3.63-15.81). The merged ORs for mortality in hospital and intensive care unit were 3.33 (95% CI = 2.02-5.49) and 7.50 (95% CI = 4.60-12.21), respectively.
  
  
  CONCLUSIONS
  Reintubation can represent a threat to survival and increase the risk of VAP. The risk of mortality after reintubation differs between planned and unplanned extubation. Extubation failure is associated with a higher risk of VAP in the cardiac surgery population than in the general population.
authors.affiliation: Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Gao
authors.affiliation: Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Yang
authors.affiliation: Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Hai-Rong
authors.initials: HR
authors.lastname: He
authors.affiliation: Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China; Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Xian-Cang
authors.initials: XC
authors.lastname: Ma
authors.affiliation: Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Ya-Jing
authors.initials: YJ
authors.lastname: Zhai
authors.affiliation: Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Li-Tao
authors.initials: LT
authors.lastname: Guo
authors.affiliation: Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Wang
authors.affiliation: Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China. Electronic address: Jiezheng_xjtucrc@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
mesh_terms: D060666:Airway Extubation / Q000379:methods; D006348:Cardiac Surgical Procedures; D014943:Global Health; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000379:methods*; D016017:Odds Ratio; D053717:Pneumonia, Ventilator-Associated / Q000401:mortality* / Q000628:therapy; D011183:Postoperative Complications; D012121:Respiration, Artificial; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: Extubation failure; Mortality; Reintubation; Ventilator-associated pneumonia