• Crit Care Resusc · Dec 2006

    The effect of extubation failure on outcome in a multidisciplinary Australian intensive care unit.

    • John R Gowardman, David Huntington, and Joy Whiting.
    • Intensive Care Unit, The Canberra Hospital, Canberra, ACT, Australia. john_gowardman@health.qld.gov.au
    • Crit Care Resusc. 2006 Dec 1;8(4):328-33.

    BackgroundA reported association between extubation failure (EF) and increased hospital length of stay and mortality led us to assess outcome of EF in an Australian intensive care unit.Design And SettingNon-interventional cohort study in the intensive care/high dependency unit of a tertiary referral hospital, 2000-2003.MethodsEF was defined as reintubation within 72 hours of extubation. Causes of EF were determined by review of the clinical notes and prospective record of the EF event. Patients were excluded if they were aged < or = 14 years, self-extubated, were reintubated to replace a defective endotracheal tube, or had been extubated but were returning to the operating theatre. Physiological variables used to calculate severity of illness score were analysed to ascertain correlation with EF.Results2761 patients were electively extubated, and 52 (1.8%) fulfilled the criteria for EF. Compared with those successfully extubated, EF patients had a higher 24 h APACHE II score (18.0+/-7.0 [mean+/-SD] v 15.3+/-7.4, P=0.009), significant increases in length of stay in ICU (12.8+/-8.3 v 3.0+/-6.0 days, P<0.001) and hospital (33.5 +/-40.8 v 18.0+/-28.6 days, P<0.001) and tracheostomy rate (38.5% v 3.5%, P<0.001). The commonest cause of EF was excess secretions or aspiration (32%). EF was independently associated with hospital mortality (odds ratio [OR], 2.10; 95% CI, 1.00-4.41; P=0.048) and low serum albumin level on admission (OR, 0.75; 95% CI, 0.55-1.00; P=0.05). Neither aetiology of airway failure (OR, 2.21; 95% CI, 0.56- 8.75; P=0.25) nor time to reintubation (OR, 0.99; 95% CI, 0.97-1.01; P=0.76) were associated with mortality.ConclusionOur findings confirm an increased risk of adverse outcomes for patients with EF. We observed a comparatively low EF rate. Confirmation in similar patient cohorts is required.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…