• Karla M Greco, Bianca M Conti, Cynthia J Bucci, and Samuel M Galvagno.
• Division of Trauma Anesthesiology, Department of Anesthesiology, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD 21201. Electronic address: kgreco@anes.umm.edu.
• J Clin Anesth. 2016 Nov 1; 34: 186-91.

Study ObjectiveTo determine risk factors associated with reintubations in adult patients with soft tissue infections.DesignA retrospective case-control design.SettingOperating room and postoperative recovery area.PatientsThere were 39 patients who presented for surgical intervention of their soft tissue infection and 222 controls having general surgery who were matched for age, sex, and body mass index. All patients were older than the age of 18 years and mostly American Society of Anesthesiologists physical status of III to IV and presented to our level 1 trauma center.InterventionsReintubation within 2 hours after planned extubation.MeasurementsThe following data were collected: reintubation rates, train of four ratio, reversal agents, age, sex, creatinine, smoking history, transfusion requirements, Sequential Organ Failure Assessment score, hemoglobin, and lactate.Main ResultsThe use of rocuronium was independently associated with increased odds of reintubation. Patients with a higher train of four ratio were more likely to be reintubated and less likely to be reversed as compared to those with a lower train of four ratio.ConclusionsSoft tissue patients who have received rocuronium are at increased risk for reintubation, particularly those with renal failure. In addition, this article supports the use of neuromuscular blockade reversals, even in patients with a strong train of four ratio.Copyright © 2016 Elsevier Inc. All rights reserved.

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