• Pediatric Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal, São Paulo, Brazil. Electronic address: psls.nat@terra.com.br.
• J Crit Care. 2016 Dec 1; 36: 97-101.

PurposeSeveral studies have suggested worse outcomes for patients requiring medical care at night or on weekends. However, whether or not children should be extubated only during in-hours has not been studied yet. We sought to compare outcomes and complications of in-hours versus off-hours extubated patients.MethodsWe prospectively included all children receiving invasive mechanical ventilation (MV) in a pediatric intensive care unit. Off-hours extubations included patients who were extubated at nighttime (8:00 pm-7:59 am) plus weekends/holidays whereas the in-hours extubations included regular daytime weekdays (Monday to Friday: 8:00 am-7:59 pm).ResultsOf the 480 patients, 346 (72%) were extubated during in-hours period and 134 (28%) were extubated during off-hours. In-hours patients spent a longer time to have planned extubation and had a longer MV duration and pediatric intensive care unit stay compared to those extubated at off-hours. Kaplan-Meier curve showed that in-hours patients were more likely to have a longer time until the first extubation (log-rank test: P=.006, HR: 5.05).ConclusionPatients extubated at off-hours had more favorable outcomes with similar complications rate compared with those extubated at in-hours. These results provide no support for delaying extubations until in-hours period. Further studies are required to confirm these findings.Copyright © 2016 Elsevier Inc. All rights reserved.

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