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Extubation failure can directly worsen patient outcomes. Therefore, the decision to extubate is a critical moment during an intensive care unit (ICU) stay. The decision to extubate is usually made after a weaning readiness test involving spontaneous breathing on a T-piece or low levels of ventilatory assistance. However, extubation failure still occurs in 10 to 20% of patients. The investigators focused on previously reported physiological risk factors, and were able to obtain from common clinical practice: 1) age, 2) underlying cardiovascular disease, 3) underlying respiratory disease or occurrence of pneumonia, 4) rapid shallow breathing index (RSBI), 5) positive fluid balance during the previous 24 hours, 6) the ratio of arterial oxygen partial pressure to fractional inspired oxygen, 7) Glasgow Coma Scale, 8) respiratory tract secretions. The investigators aimed to assess the incidence and risk factors for extubation failure among critically ill patients who passed the 30 min spontaneous breathing test (SBT) using a low level of pressure support (PS) with positive end-expiratory pressure (PEEP), in a prospective multicenter study.
Primary Outcome Measures:
Reintubation within 48 hours after extubation (logistic regression will be used to assess the risk factors)
Secondary Outcome Measures:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Successful extubation | extubated successfully | ||
| Extubation failure | reintubated within 48 hours | ||
| NPPV/NHF | use of non-invasive positive pressure ventilation (NPPV) or nasal high flow (NHF) within 48 hours after extubation |
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| Measure | Description | Time Frame |
|---|---|---|
| Implementation of reintubation within 48 hours after extubation | logistic regression will be used to identify risk factors | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Use of non-invasive positive pressure ventilation or nasal high flow within 48 hours after extubation | logistic regression will be used to identify risk factors | 48 hours |
| Length of ICU and hospital stay, |
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Inclusion Criteria:
Exclusion Criteria:
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All adult patients extubated in the ICU
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| Name | Affiliation | Role |
|---|---|---|
| Yuji Fujino | Department of Anesthesiology and Intensive Care Medicine, Osaka University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesiology and Intensive Care Medicine, Osaka University | Suita | Osaka | 565-0871 | Japan |
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mean(standard deviation) or medians (interquartiles 25%-75%) and compared using the student t test or Wilcoxon test as appropriate
| 28 days |
| vital status at ICU and hospital discharge, 28-day mortality | mean(standard deviation) or medians (interquartiles 25%-75%) and compared using the student t test or Wilcoxon test as appropriate | 28 days |