• Fan Gao, Li-Hong Yang, Hai-Rong He, Xian-Cang Ma, Jun Lu, Ya-Jing Zhai, Li-Tao Guo, Xue Wang, and Jie Zheng.
• Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, China.
• Heart Lung. 2016 Jul 1; 45 (4): 363-71.

ObjectivesThis meta-analysis summarized the risks that reintubation impose on ventilator-associated pneumonia (VAP) and mortality.BackgroundExtubation failure increases the probability of poor clinical outcomes pertaining to mechanical ventilation.MethodsLiterature 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.ResultsForty-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.ConclusionsReintubation 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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