Epstein Scott K
Department of Medicine, Caritas-St Elizabeth's Medical Center, and Professor of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA.
Crit Care. 2004 Oct;8(5):310-2. doi: 10.1186/cc2927. Epub 2004 Aug 10.
Extubation failure is an outcome of increasing importance but nearly all studies have been conducted in academic settings. The article by Seymour and colleagues demonstrates that extubation failure is an outcome to be avoided in the community hospital setting as well. Patients failing extubation experience longer lengths of stay, experience higher intensive care unit mortality, and incur greater hospital costs. Investigators have identified tools for predicting extubated patients at highest risk for reintubation. The predictors focus on detecting upper airway obstruction, inadequate cough, excess respiratory secretions, and abnormal mental status. Systematic application of these predictors has the potential to improve outcome.
拔管失败是一个日益重要的结果，但几乎所有研究都是在学术环境中进行的。西摩及其同事的文章表明，拔管失败也是社区医院环境中应避免出现的结果。拔管失败的患者住院时间更长，重症监护病房死亡率更高，住院费用也更高。研究人员已经确定了预测再次插管风险最高的拔管患者的工具。这些预测指标侧重于检测上呼吸道阻塞、咳嗽不足、呼吸道分泌物过多和精神状态异常。系统应用这些预测指标有可能改善结果。
