Table 1.
Patient Characteristics at Baseline
| Patient Characteristic | Protocolized Support (n = 359) |
Usual Care (n = 392) |
|---|---|---|
| Age, median (IQR), yr | 56 (43–66) | 57 (42–66) |
| Sex, M, n (%) | 204 (56.8) | 205 (52.3) |
| White race*, n (%) | 287 (81.3) | 317 (81.7) |
| Body mass index†, median (IQR), kg/m2 | 26.6 (23.0–31.7) | 28.0 (23.2–33.8) |
| Chronic respiratory comorbidity‡, n (%) | 138 (38.4) | 163 (41.6) |
| Chronic obstructive pulmonary disease | 58 (16.2) | 87 (22.2) |
| Asthma | 21 (5.8) | 18 (4.6) |
| Obstructive sleep apnea | 39 (10.9) | 47 (12.0) |
| Pulmonary malignancy | 14 (3.9) | 16 (4.1) |
| Indications for intubation‡, n (%) | ||
| Airway protection for decreased level of consciousness | 180 (50.1) | 168 (42.9) |
| Hypoxemic respiratory failure | 141 (39.3) | 175 (44.6) |
| Hypercarbic respiratory failure | 42 (11.7) | 65 (16.6) |
| Preprocedural | 45 (12.5) | 36 (9.2) |
| Duration of invasive mechanical ventilation before extubation, d, median (IQR) | 3.0 (2.0–5.0) | 3.0 (2.0–4.0) |
| Unplanned extubation | 17 (4.7%) | 27 (6.9%) |
| APACHE II score at ICU admission§, median (IQR) | 19 (12–24) | 18 (13–24) |
| APACHE II score at extubation§, median (IQR) | 17 (13–22) | 17 (12–22) |
| Active medical conditions‡, n (%) | ||
| Sepsis or septic shock | 136 (37.9) | 146 (37.2) |
| Pneumonia | 135 (37.6) | 135 (34.4) |
| Acute respiratory distress syndrome | 23 (6.4) | 21 (5.4) |
| Aspiration | 44 (12.3) | 57 (14.5) |
| Gastrointestinal bleeding | 45 (12.5) | 42 (10.7) |
| Altered mental status | 190 (52.9) | 204 (52.0) |
| Vasopressors in the 6 h before extubation, n (%) | 47 (13.1) | 48 (12.2) |
| Failed one or more spontaneous breathing trial, n (%) | 83 (23.1) | 80 (20.4) |
| Highest respiratory rate on a spontaneous breathing trial‖ | 22 (17–28) | 22 (18–28) |
| At least one risk factor for reintubation¶ | 316 (88.0) | 350 (89.3) |
Definition of abbreviations: APACHE II = Acute Physiology and Chronic Health Evaluation; IQR = interquartile range.
Race was reported by patients or their surrogates and recorded in the electronic health record as a part of routine clinical care. Race was missing for 10 patients (1.3%): 6 patients in the protocolized support group and 4 patients in the usual care group.
Information on body mass index at enrollment was missing for 21 patients (2.8% patients): 13 from the protocolized support group and 8 from the usual care group.
Patients could have more than one.
APACHE II score ranges from 0 to 71, with higher scores indicating higher severity of illness.
Respiratory rate on spontaneous breathing trial was missing for 41 patients (5.4% patients): 14 from the protocolized support group and 27 from the usual care group.
Risk factors for reintubation, as defined by Hernández and colleagues (17, 33), included age >65 years, heart failure, moderate to severe chronic obstructive pulmonary disease, APACHE II score at extubation >12, body mass index >30 kg/m2, failure of >1 spontaneous breathing trial, and duration of mechanical ventilation ⩾7 days.