Silvério Thamires de Carvalho, Prado Cristiane do, Nascimento Milena Siciliano
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2025 May 12;23:eAO0705. doi: 10.31744/einstein_journal/2025AO0705. eCollection 2025.
The study demonstrated that extubation failure prolonged the total duration of mechanical ventilation to twice that observed in patients with successful extubation. These findings emphasize the critical need for daily patient assessment guided by well-defined clinical criteria to ensure mechanical ventilation is discontinued precisely when the patient is clinically prepared-neither prematurely nor unnecessarily delayed. ■ In patients who experienced extubation failure, the total ventilation time was twice as long as that of patients with successful extubation. ■ The incidence of extubation failure was 5.2%, which is relatively low compared to other studies. ■ The study revealed no significant association between the presence of pre-existing illnesses and extubation outcomes. ■ Results indicated that the primary cause of extubation failure was upper airway obstruction, accounting for 67% of cases requiring reintubation.
To compare the epidemiological profiles of patients who experienced extubation failure with those who achieved success and to evaluate the impact of extubation failure on total mechanical ventilation duration.
An observational study with both retrospective and prospective components was conducted on patients admitted to the Pediatric Intensive Care Unit of a private hospital. This study included patients who underwent mechanical ventilation and were extubated between January 2017 and December 2022. Patients were classified into extubation Success or Failure Groups, with failure defined as requiring a return to invasive mechanical ventilation within 48hs post-extubation. Epidemiological factors, including age, pre-existing illnesses, and time on invasive mechanical ventilation, were analyzed.
A total of 173 patients were included, of which 9 (5.2%) required reintubation within 48hs. The total duration of mechanical ventilation differed significantly between the Success Group (3 days [1.8; 6.6]) and the Failure Group (6.5 days [5.6; 9.3]), p=0.004. Upper airway obstruction was identified as the primary cause of extubation failure.
This study demonstrated that extubation failure doubled the total duration of mechanical ventilation compared to successful extubation. These findings highlight the importance of daily patient assessment with clearly defined clinical criteria to ensure mechanical ventilation is discontinued precisely when the patient is ready-neither prematurely nor excessively delayed.
该研究表明，拔管失败会使机械通气的总时长延长至成功拔管患者的两倍。这些发现强调了迫切需要依据明确的临床标准对患者进行每日评估，以确保在患者临床状况准备好时准确停止机械通气，既不过早也不过度延迟。
■ 在经历拔管失败的患者中，总通气时间是成功拔管患者的两倍。
■ 拔管失败的发生率为5.2%，与其他研究相比相对较低。
■ 该研究表明，既往疾病的存在与拔管结果之间无显著关联。
■ 结果表明，拔管失败的主要原因是上呼吸道梗阻，占需要重新插管病例的67%。
比较拔管失败患者与成功患者的流行病学特征，并评估拔管失败对机械通气总时长的影响。
对一家私立医院儿科重症监护病房收治的患者进行了一项兼具回顾性和前瞻性的观察性研究。该研究纳入了2017年1月至2022年12月期间接受机械通气并拔管的患者。患者被分为拔管成功组或失败组，失败定义为拔管后48小时内需要恢复有创机械通气。分析了包括年龄、既往疾病和有创机械通气时间等流行病学因素。
共纳入173例患者，其中9例（5.2%）在48小时内需要重新插管。成功组（3天[1.8；6.6]）和失败组（6.5天[5.6；9.3]）的机械通气总时长差异显著，p = 0.004。上呼吸道梗阻被确定为拔管失败的主要原因。
该研究表明，与成功拔管相比，拔管失败使机械通气总时长增加了一倍。这些发现凸显了依据明确的临床标准对患者进行每日评估的重要性，以确保在患者准备好时准确停止机械通气，既不过早也不过度延迟。
