• Fernando Frutos-Vivar, Andrés Esteban, Carlos Apezteguia, Marco González, Yaseen Arabi, Marcos I Restrepo, Federico Gordo, Cristina Santos, Jamal A Alhashemi, Fernando Pérez, Oscar Peñuelas, and Antonio Anzueto.
• Hospital Universitario de Getafe and CIBER Enfermedades Respiratorias, Madrid, Spain.
• J Crit Care. 2011 Oct 1; 26 (5): 502-509.

PurposeThe main objective of study was to evaluate the outcome of patients who require reintubation after elective extubation.Materials And MethodsThis is an observational, prospective cohort study including mechanically ventilated patients who passed successfully a spontaneous breathing trial. Patients were observed for 48 hours after extubation. During this time, reintubation or use of noninvasive positive pressure ventilation was considered as a failure. Reintubated patients were followed after the reintubation to register complications and outcome.ResultsA total of 1,152 extubated patients were included in the analysis. Three hundred thirty-six patients (29%) met the criteria for extubation failure. Extubation failure was independently associated with mortality (odds ratio, 3.29; 95% confidence interval, 2.19-4.93). One hundred eighty patients (16% of overall cohort) required reintubation within 48 hours after extubation. Median time from extubation to reintubation was 13 hours (interquartile range, 6-24 hours). Reintubation was independently associated with mortality (odds ratio, 5.18; 95% confidence interval, 3.38-7.94; P < .001). Higher mortality of reintubated patients was due to the development of complications after the reintubation.ConclusionsIn a large cohort of scheduled extubated patients, one third of patients developed extubation failure, of whom half needed reintubation. Reintubation was associated with increased mortality due to the development of new complications after reintubation.Copyright © 2011 Elsevier Inc. All rights reserved.

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