Extubation failure is usually defined as the need for reintubation within 48–72 h following extubation . Patients may be unable to maintain spontaneous breathing for multiple reasons: increased workload of breathing, cardiovascular dysfunction, airway obstruction, or excessive secretions. The incidence of post-extubation respiratory failure ranges between 10 and 20 % . Patients who fail extubation have higher mortality, consistently reported at about 20–50 % in intensive care units (ICUs), and longer ICU and hospital stays . Reintubation is a risk factor for ventilator-associated pneumonia  and is independently associated with ICU mortality [3, 5, 6]. A minority of reintubated patients die in the first 24 h after reintubation, whereas mortality increases with time to reintubation . Moreover, upper-airway obstruction is the reason for reintubation in about 5–15 % of cases, but no increase in mortality has been reported in this population . Thus, three scenarios explain the higher mortality rate: (1) reintubation entails risks per se, (2) it is a marker for severity of illness, or (3) it is a consequence of a new event occurring between extubation and reintubation.
|Title of host publication||Noninvasive Mechanical Ventilation and Difficult Weaning in Critical Care: Key Topics and Practical Approaches|
|Publisher||Springer International Publishing|
|Number of pages||15|
|ISBN (Print)||9783319042596, 9783319042589|
|Publication status||Published - Jan 1 2016|
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