• Milena Carlos Vidotto, Luciana Carrupt Machado Sogame, Mariana Rodrigues Gazzotti, Mirto Nelson Prandini, and José Roberto Jardim.
• Department of Physiotherapy, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
• Resp Care. 2012 Dec 1;57(12):2059-66.

BackgroundExtubation failure is defined as the re-institution of respiratory support ranging from 24 to 72 hours following scheduled extubation and occurs in 2% to 25% of extubated patients. The aim of this study was to determine clinical and surgical risk factors that may predict extubation failure in patients submitted to non-emergency intracranial surgery.MethodsThis was a prospective observational cohort study. The study was carried out on 317 subjects submitted to non-emergency intracranial surgery for tumors, aneurysms, and arteriovenous malformation. Preoperative assessment was performed and subjects were followed up for the determination of extubation failure until either discharge from hospital or death.ResultsTwenty-six (8.2%) of the 317 subjects experienced extubation failure following surgery. The following variables were considered for the multivariate analysis: level of consciousness at the time of extubation, duration of mechanical ventilation prior to extubation, sex and the use of intraoperative mannitol. The multivariate analysis determined that the most important variable for extubation failure was the level of consciousness at the time of extubation (P = .001), followed by female sex, which also showed to be significant (P = .006).ConclusionsLower level of consciousness (GCS 8T-10T) and female sex were considered risk factors for extubation failure in subjects submitted to elective intracranial surgery.

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