Extubation of the Difficult Airway and Extubation Failure

Cavallone, Laura F.; Vannucci, Andrea

doi:10.1097/01.sa.0000435464.98907.2d

Cited by 37 publications

(64 citation statements)

References 5 publications

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“…7,8 Extubation failure is often defined as the need for re-intubation within 24 -72 h of a planned extubation 8 ; however, this definition does not differentiate between the two primary types of failure. Increasingly, therefore, the term extubation failure has been used to refer to "the inability to tolerate removal of the translaryngeal tube," 7,8 whereas weaning or liberation failure is used to refer to the inability to tolerate spontaneous ventilation without mechanical support. 7,9 The incidences of extubation and liberation failure vary depending on both the clinical setting and patient factors.…”

Section: Extubation Failurementioning

confidence: 99%

“…Increasingly, therefore, the term extubation failure has been used to refer to "the inability to tolerate removal of the translaryngeal tube," 7,8 whereas weaning or liberation failure is used to refer to the inability to tolerate spontaneous ventilation without mechanical support. 7,9 The incidences of extubation and liberation failure vary depending on both the clinical setting and patient factors. In general, re-intubation is relatively uncommon after general anesthesia for elective surgery, with reported rates of 0.1-0.45%.…”

Section: Extubation Failurementioning

confidence: 99%

“…In general, re-intubation is relatively uncommon after general anesthesia for elective surgery, with reported rates of 0.1-0.45%. 7 The most common causes for re-intubation include respiratory insufficiency, airway obstruction, bronchospasm, residual neuromuscular blockade, residual effects of sedatives/opioids, and aggressive fluid administration. 7 In the ICU, where patients are mechanically ventilated as they recover from acute respiratory failure, re-intubation is predictably more common, with rates of 2-25%.…”

Section: Extubation Failurementioning

confidence: 99%

“…7 The most common causes for re-intubation include respiratory insufficiency, airway obstruction, bronchospasm, residual neuromuscular blockade, residual effects of sedatives/opioids, and aggressive fluid administration. 7 In the ICU, where patients are mechanically ventilated as they recover from acute respiratory failure, re-intubation is predictably more common, with rates of 2-25%. 9 Extubation and liberation failure are frequently linked in the ICU population 7 and can be a result of upper airway obstruction, excess secretions, inability to protect the airway, concomitant failure of other organ systems, or an imbalance between the work of breathing and respiratory muscle capacity.…”

Section: Extubation Failurementioning

confidence: 99%

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Tracheal ExtubationDiscussion

Artime¹,

Hagberg²

2014

Respir Care

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Tracheal extubation in both the critical care and anesthesia setting is not only an important milestone for patient recovery, but also a procedure that carries a considerable risk of complication or failure. Mechanical ventilation is associated with significant complications that are time-dependent in nature, with a longer duration of intubation resulting in a higher incidence of complications, including ventilator-associated pneumonia, and increased mortality. Extubation failure and subsequent re-intubation are associated with an overall increase in the duration of mechanical ventilation, increased mortality, a greater need for tracheostomy, and higher medical costs. These risks demand that the process of extubation be managed by practitioners with a detailed understanding of the causes of extubation failure and the potential complications. A pre-established extubation plan with considerations made for the possible need for re-intubation is of the utmost importance.

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Section: Extubation Failurementioning

confidence: 99%

Section: Extubation Failurementioning

confidence: 99%

Section: Extubation Failurementioning

confidence: 99%

Section: Extubation Failurementioning

confidence: 99%

See 2 more Smart Citations

Tracheal ExtubationDiscussion

Artime¹,

Hagberg²

2014

Respir Care

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“…Critical phases in terms of the potential occurrence of severe airway complications in the operating room include not only the induction of anesthesia but also the emergence from anesthesia [1,10,11]. The Practice Guidelines for Management of the Difficult Airway by the American Society of Anesthesiologists include extubation strategies for patients with DA [5].…”

Section: Future Directionsmentioning

confidence: 99%

Is the light green for your airway management?

Isono

2014

J Anesth

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Perioperative care of the obese patient

Carron

Fakhr

Ieppariello

et al. 2020

British Journal of Surgery

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Background Obesity has become an increasing problem worldwide during the past few decades. Hence, surgeons and anaesthetists will care for an increasing number of obese patients in the foreseeable future, and should be prepared to provide optimal management for these individuals. This review provides an update of recent evidence regarding perioperative strategies for obese patients. Methods A search for papers on the perioperative care of obese patients (English language only) was performed in July 2019 using the PubMed, Scopus, Web of Science and Cochrane Library electronic databases. The review focused on the results of RCTs, although observational studies, meta‐analyses, reviews, guidelines and other reports discussing the perioperative care of obese patients were also considered. When data from obese patients were not available, relevant data from non‐obese populations were used. Results and conclusion Obese patients require comprehensive preoperative evaluation. Experienced medical teams, appropriate equipment and monitoring, careful anaesthetic management, and an adequate perioperative ventilation strategy may improve postoperative outcomes. Additional perioperative precautions are necessary in patients with severe morbid obesity, metabolic syndrome, untreated or severe obstructive sleep apnoea syndrome, or obesity hypoventilation syndrome; patients receiving home ventilatory support or postoperative opioid therapy; and obese patients undergoing open operations, long procedures or revisional surgery.

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Extubation of the Difficult Airway and Extubation Failure

Cited by 37 publications

References 5 publications

Tracheal ExtubationDiscussion

Tracheal ExtubationDiscussion

Is the light green for your airway management?

Perioperative care of the obese patient

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