To determine whether mental status (MS), cough peak flows (CPF) and endotracheal secretions (ES) affect extubation (EXT) outcomes.
We prospectively examined MS, CPF and ES of 86 patients recovering from respiratory failure who had passed a SBT.
20 patients failed their initial EXT within 72 h. CPFs of failed patients was lower than successes (38±28 L/min vs. 65±33 L/min, p=0.002). Those with CPF<60 L/min were 4-times as likely to fail EXT compared to those with CPF 60 L/min or more (95% CI=1.3–12.9). Patients unable to complete any of 4 simple tasks (follow with eyes, open eyes, stick out tongue, grasp hand) were twice as likely to fail (95%CI=0.9-4.2). Those able to complete all 4 tasks but with CPF<60 L/min were twice as likely to fail (95%CI=1.4-2.7). Those with a required suctioning frequency of <2 h were twice as likely to fail (95%CI=1-5.3). These three “risk factors” (i.e. <4 tasks, <60 L/min, <2 h) were additive in predicting failure (see Figure).
CPF, MS and ES contribute to EXT outcomes of patients who have passed a SBT.
These quantifiable determinants of EXT outcome may be used to stratify pre-EXT risk of failure.
Cong Stonestreet, None.