| Title |
Risk factors and outcomes for airway failure versus non-airway failure in the intensive care unit: a multicenter observational study of 1514 extubation procedures
|
|---|---|
| Published in |
Critical Care, September 2018
|
| DOI | 10.1186/s13054-018-2150-6 |
| Pubmed ID | |
| Authors |
Samir Jaber, Hervé Quintard, Raphael Cinotti, Karim Asehnoune, Jean-Michel Arnal, Christophe Guitton, Catherine Paugam-Burtz, Paer Abback, Armand Mekontso Dessap, Karim Lakhal, Sigismond Lasocki, Gaetan Plantefeve, Bernard Claud, Julien Pottecher, Philippe Corne, Carole Ichai, Zied Hajjej, Nicolas Molinari, Gerald Chanques, Laurent Papazian, Elie Azoulay, Audrey De Jong |
| Abstract |
Patients liberated from invasive mechanical ventilation are at risk of extubation failure, including inability to breathe without a tracheal tube (airway failure) or without mechanical ventilation (non-airway failure). We sought to identify respective risk factors for airway failure and non-airway failure following extubation. The primary endpoint of this prospective, observational, multicenter study in 26 intensive care units was extubation failure, defined as need for reintubation within 48 h following extubation. A multinomial logistic regression model was used to identify risk factors for airway failure and non-airway failure. Between 1 December 2013 and 1 May 2015, 1514 patients undergoing extubation were enrolled. The extubation-failure rate was 10.4% (157/1514), including 70/157 (45%) airway failures, 78/157 (50%) non-airway failures, and 9/157 (5%) mixed airway and non-airway failures. By multivariable analysis, risk factors for extubation failure were either common to airway failure and non-airway failure: intubation for coma (OR 4.979 (2.797-8.864), P < 0.0001 and OR 2.067 (1.217-3.510), P = 0.003, respectively, intubation for acute respiratory failure (OR 3.395 (1.877-6.138), P < 0.0001 and OR 2.067 (1.217-3.510), P = 0.007, respectively, absence of strong cough (OR 1.876 (1.047-3.362), P = 0.03 and OR 3.240 (1.786-5.879), P = 0.0001, respectively, or specific to each specific mechanism: female gender (OR 2.024 (1.187-3.450), P = 0.01), length of ventilation > 8 days (OR 1.956 (1.087-3.518), P = 0.025), copious secretions (OR 4.066 (2.268-7.292), P < 0.0001) were specific to airway failure, whereas non-obese status (OR 2.153 (1.052-4.408), P = 0.036) and sequential organ failure assessment (SOFA) score ≥ 8 (OR 1.848 (1.100-3.105), P = 0.02) were specific to non-airway failure. Both airway failure and non-airway failure were associated with ICU mortality (20% and 22%, respectively, as compared to 6% in patients with extubation success, P < 0.0001). Specific risk factors have been identified, allowing us to distinguish between risk of airway failure and non-airway failure. The two conditions will be managed differently, both for prevention and curative strategies. ClinicalTrials.gov, NCT 02450669 . Registered on 21 May 2015. |
X Demographics
The data shown below were collected from the profiles of 44 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 6 | 14% |
| Spain | 5 | 11% |
| United States | 4 | 9% |
| Brazil | 3 | 7% |
| Ecuador | 3 | 7% |
| Canada | 2 | 5% |
| Mexico | 2 | 5% |
| United Kingdom | 2 | 5% |
| France | 1 | 2% |
| Other | 5 | 11% |
| Unknown | 11 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 33 | 75% |
| Practitioners (doctors, other healthcare professionals) | 7 | 16% |
| Science communicators (journalists, bloggers, editors) | 2 | 5% |
| Scientists | 2 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 122 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 122 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 15 | 12% |
| Other | 11 | 9% |
| Student > Master | 9 | 7% |
| Student > Ph. D. Student | 8 | 7% |
| Student > Doctoral Student | 8 | 7% |
| Other | 30 | 25% |
| Unknown | 41 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 39 | 32% |
| Nursing and Health Professions | 18 | 15% |
| Engineering | 6 | 5% |
| Neuroscience | 3 | 2% |
| Unspecified | 2 | 2% |
| Other | 6 | 5% |
| Unknown | 48 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 November 2022.
All research outputs
#1,551,023
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Outputs from Critical Care
#1,369
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Outputs of similar age
#32,559
of 350,796 outputs
Outputs of similar age from Critical Care
#44
of 102 outputs
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