%0 Journal Article %A Chun-Ta Huang %A Chong-Jen Yu %T Conventional weaning parameters do not predict extubation outcome in intubated patients requiring prolonged mechanical ventilation %D 2013 %R 10.4187/respcare.01773 %J Respiratory Care %P respcare.01773 %X Background: Approaches to respiratory care of patients needing prolonged mechanical ventilation (PMV) might be varied. In this study, we assessed the predictive value of usual variables for extubation outcome in PMV patients. Methods: From 2005 to 2007, intubated patients who were admitted to the intermediate respiratory care unit, had been placed on mechanical ventilation for ≧21 days at the time of admission, and underwent extubation after successful spontaneous breathing trials were included. Comparisons between patients with successful extubation and failed extubation in terms of weaning parameters and clinical predictors of extubation outcome were performed. Also, one-year survival of patients with regard to extubation outcome was analyzed. Results: Twenty seven (23.7%) of 119 PMV patients required reintubation within 7 days. Multivariate logistic regression analysis demonstrated the only variable associated with extubation failure was ineffective cough (p <0.001). Possessing two or more acceptable weaning parameters was not helpful in predicting extubation outcome. Patients with failed extubation had worse one-year survival (HR, 0.491; 95% CI, 0.277-0.871; p =0.015) compared with those with successful extubation. Conclusions: In PMV patients who tolerated spontaneous breathing trials and were ready to extubate, ineffective cough was the best predictor of extubation failure. Furthermore, extubation failure was associated with future mortality; thus, different management strategies need to be developed for improving patient outcome. %U https://rc.rcjournal.com/content/respcare/early/2013/01/08/respcare.01773.full.pdf