Clinical Practices of Extubation After Invasive Mechanical Ventilation

Clinical Practices of Extubation After Invasive Mechanical Ventilation in Anesthesia and Intensive Care

Extubation is a delicate and complex phase of airway management in anesthesia and critical care. A variety of complications are of concern, ranging from transient hypoxemia to the need for reintubation, which can then become life-threatening for the patient.

For this procedure, it may be recommended to use the positive end-expiratory pressure (PEEP) extubation technique to reduce the risks of hypoxemia, atelectasis, and aspiration. However, no specific technique is preferred given the diversity of described procedures (spontaneous ventilation on an auxiliary circuit, PEEP-assisted spontaneous ventilation, adjustment of the APL valve). However, results may vary depending on the patient population (children, adults) and the setting (operating room, intensive care unit).

Given the lack of a preferred technique for performing extubation under positive end-expiratory pressure, the aim of this study is to describe the techniques used by healthcare professionals (physicians, nurse anesthetists, nurses) during the extubation of a surgical or intensive care patient.

Inclusion Criteria:

• Physicians and students in anesthesiology and critical care,
• Critical care physicians,
• State-certified nurse anesthetists (IADE),
• State-certified nurses (IDE) working in an anesthesia or intensive care team
• Students (medical or nurse anesthetist) with at least 1 year of extubation experience.

Exclusion Criteria:

• Healthcare professionals with no experience in extubation (less than one year of practice) Refusal to participate