Table III.
Primary causes of extubation failure and reintubation [n (%)].
| Cause | Reintubation (n=72) | Extubation failure (n=90) |
|---|---|---|
| No improvement in signs of muscle fatiguea | 25 (34.7) | 37 (41.1) |
| Hypoxemia | 27 (37.5) | 31 (34.4) |
| No improvement in respiratory acidosis | 5 (6.9) | 7 (7.8) |
| Neurological deteriorationb | 6 (8.3) | 6 (6.7) |
| Excess respiratory secretions | 4 (5.6) | 4 (4.4) |
| Hemodynamic instabilityc | 5 (7.0) | 5 (5.6) |
a
Such as the use of respiratory accessory muscles, paradoxical abdominal motion, or retraction of the intercostal spaces.
b
Defined as the presence of at least one of the following: i) Psychomotor agitation inadequately controlled by sedation; and ii) decreased consciousness, rendering the patient unable to tolerate noninvasive ventilation (NIV).
c
With a systolic blood pressure <90 mmHg despite adequate volume challenge, the use of vasopressors, or both. Extubation failure includes re-intubated patients and patients who remained on NIV rescue therapy within 48 h following extubation.