• Anaesth Intensive Care · Jun 2004

    Case Reports

    Difficult extubation: calming the sympathetic storm.

    • A Kulkarni, G Price, M Saxena, and G Skowronski.
    • Intensive Care Unit, The St. George Hospital, Sydney, New South Wales.
    • Anaesth Intensive Care. 2004 Jun 1; 32 (3): 413-6.

    AbstractTracheal extubation can evoke an equally strong haemodyamic stress response as tracheal intubation. We present a patient with myocardial infarction who repeatedly failed tracheal extubation. He developed acute pulmonary oedema following each attempt at tracheal extubation due to sympathetic overactivity. A change of approach with extubation under propofol sedation followed by continued sympatholysis with dexmedetomidine infusion allowed successful extubation.

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