Abstract
Tracheal extubation in both the critical care and anesthesia setting is not only an important milestone for patient recovery, but also a procedure that carries a considerable risk of complication or failure. Mechanical ventilation is associated with significant complications that are time-dependent in nature, with a longer duration of intubation resulting in a higher incidence of complications, including ventilator-associated pneumonia, and increased mortality. Extubation failure and subsequent re-intubation are associated with an overall increase in the duration of mechanical ventilation, increased mortality, a greater need for tracheostomy, and higher medical costs. These risks demand that the process of extubation be managed by practitioners with a detailed understanding of the causes of extubation failure and the potential complications. A pre-established extubation plan with considerations made for the possible need for re-intubation is of the utmost importance.
- airway exchange catheters
- airway management
- difficult airway
- extubation
- laryngeal mask airway
- ventilator weaning
- noninvasive ventilation
Footnotes
- Correspondence: Carlos A Artime MD, Department of Anesthesiology, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.020, Houston, TX 77030. E-mail: carlos.artime{at}uth.tmc.edu.
Dr Hagberg presented a version of this paper at the 52nd Respiratory Care Journal Conference, “Adult Artificial Airways and Airway Adjuncts,” held June 14 and 15, 2013, in St Petersburg, Florida.
Dr Artime served on the speakers bureau and as an unpaid consultant for Mylan Pharmaceuticals and received research support from Cadence Pharmaceuticals. Dr Hagberg served as an unpaid consultant for Ambu A/S and received research support from Ambu, Cadence Pharmaceuticals, Karl Storz Endoscopy, and King Systems.
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