Occurrence and complications of tracheal reintubation in critically ill adults

Nithya Menon, Aaron M. Joffe, Steven Deem, Norbert Yanez, Andreas Grabinsky, Armagan H C Dagal, Stephen Daniel, Miriam Treggiari

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND: Timing and preparation for tracheal extubation are as critical as the initial intubation. There are limited data on specific strategies for a planned extubation. The extent to which the difficult airway at reintubation contributes to patient morbidity is unknown. The aim of the present study was to describe the occurrence and complications of failed extubation and associated risk factors, and to estimate the mortality and morbidity associated with reintubation attempts. METHODS: Cohort study of 2,007 critically ill adult patients admitted to the ICU with an ETT. Patients were classified in 2 groups, based on the requirement for reintubation: "never reintubated" versus "> 1 reintubations." Baseline characteristics, ICU and hospital stay, hospital mortality, and in-patient costs were compared between patients successfully extubated and those with reintubation outside the operating room, using regression techniques. Reasons, airway management techniques, and complications of intubation and reintubation were summarized descriptively. RESULTS: 376 patients (19%) required reintubation, and 230 (11%) were reintubated within 48 hours, primarily due to respiratory failure. Patients requiring reintubation were older, more likely to be male, and had higher admission severity score. Difficult intubation and complications were similar for initial and subsequent intubation. Reintubation was associated with a 5-fold increase in the relative odds of death (adjusted odds ratio 5.86, 95% CI 3.878.89, P

Original languageEnglish (US)
Pages (from-to)1555-1563
Number of pages9
JournalRespiratory Care
Volume57
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

Fingerprint

Critical Illness
Intubation
Odds Ratio
Airway Extubation
Morbidity
Airway Management
Operating Rooms
Hospital Mortality
Respiratory Insufficiency
Length of Stay
Cohort Studies
Costs and Cost Analysis
Mortality

Keywords

  • Airway management
  • Cohort study
  • Extubation
  • ICU
  • Mechanical ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Occurrence and complications of tracheal reintubation in critically ill adults. / Menon, Nithya; Joffe, Aaron M.; Deem, Steven; Yanez, Norbert; Grabinsky, Andreas; Dagal, Armagan H C; Daniel, Stephen; Treggiari, Miriam.

In: Respiratory Care, Vol. 57, No. 10, 10.2012, p. 1555-1563.

Research output: Contribution to journalArticle

Menon, N, Joffe, AM, Deem, S, Yanez, N, Grabinsky, A, Dagal, AHC, Daniel, S & Treggiari, M 2012, 'Occurrence and complications of tracheal reintubation in critically ill adults', Respiratory Care, vol. 57, no. 10, pp. 1555-1563. https://doi.org/10.4187/respcare.01617
Menon, Nithya ; Joffe, Aaron M. ; Deem, Steven ; Yanez, Norbert ; Grabinsky, Andreas ; Dagal, Armagan H C ; Daniel, Stephen ; Treggiari, Miriam. / Occurrence and complications of tracheal reintubation in critically ill adults. In: Respiratory Care. 2012 ; Vol. 57, No. 10. pp. 1555-1563.
@article{62b6b46f6e7343608342498f0354aeb1,
title = "Occurrence and complications of tracheal reintubation in critically ill adults",
abstract = "BACKGROUND: Timing and preparation for tracheal extubation are as critical as the initial intubation. There are limited data on specific strategies for a planned extubation. The extent to which the difficult airway at reintubation contributes to patient morbidity is unknown. The aim of the present study was to describe the occurrence and complications of failed extubation and associated risk factors, and to estimate the mortality and morbidity associated with reintubation attempts. METHODS: Cohort study of 2,007 critically ill adult patients admitted to the ICU with an ETT. Patients were classified in 2 groups, based on the requirement for reintubation: {"}never reintubated{"} versus {"}> 1 reintubations.{"} Baseline characteristics, ICU and hospital stay, hospital mortality, and in-patient costs were compared between patients successfully extubated and those with reintubation outside the operating room, using regression techniques. Reasons, airway management techniques, and complications of intubation and reintubation were summarized descriptively. RESULTS: 376 patients (19{\%}) required reintubation, and 230 (11{\%}) were reintubated within 48 hours, primarily due to respiratory failure. Patients requiring reintubation were older, more likely to be male, and had higher admission severity score. Difficult intubation and complications were similar for initial and subsequent intubation. Reintubation was associated with a 5-fold increase in the relative odds of death (adjusted odds ratio 5.86, 95{\%} CI 3.878.89, P",
keywords = "Airway management, Cohort study, Extubation, ICU, Mechanical ventilation",
author = "Nithya Menon and Joffe, {Aaron M.} and Steven Deem and Norbert Yanez and Andreas Grabinsky and Dagal, {Armagan H C} and Stephen Daniel and Miriam Treggiari",
year = "2012",
month = "10",
doi = "10.4187/respcare.01617",
language = "English (US)",
volume = "57",
pages = "1555--1563",
journal = "Respiratory Care",
issn = "0020-1324",
publisher = "Daedalus Enterprises Inc.",
number = "10",

}

TY - JOUR

T1 - Occurrence and complications of tracheal reintubation in critically ill adults

AU - Menon, Nithya

AU - Joffe, Aaron M.

AU - Deem, Steven

AU - Yanez, Norbert

AU - Grabinsky, Andreas

AU - Dagal, Armagan H C

AU - Daniel, Stephen

AU - Treggiari, Miriam

PY - 2012/10

Y1 - 2012/10

N2 - BACKGROUND: Timing and preparation for tracheal extubation are as critical as the initial intubation. There are limited data on specific strategies for a planned extubation. The extent to which the difficult airway at reintubation contributes to patient morbidity is unknown. The aim of the present study was to describe the occurrence and complications of failed extubation and associated risk factors, and to estimate the mortality and morbidity associated with reintubation attempts. METHODS: Cohort study of 2,007 critically ill adult patients admitted to the ICU with an ETT. Patients were classified in 2 groups, based on the requirement for reintubation: "never reintubated" versus "> 1 reintubations." Baseline characteristics, ICU and hospital stay, hospital mortality, and in-patient costs were compared between patients successfully extubated and those with reintubation outside the operating room, using regression techniques. Reasons, airway management techniques, and complications of intubation and reintubation were summarized descriptively. RESULTS: 376 patients (19%) required reintubation, and 230 (11%) were reintubated within 48 hours, primarily due to respiratory failure. Patients requiring reintubation were older, more likely to be male, and had higher admission severity score. Difficult intubation and complications were similar for initial and subsequent intubation. Reintubation was associated with a 5-fold increase in the relative odds of death (adjusted odds ratio 5.86, 95% CI 3.878.89, P

AB - BACKGROUND: Timing and preparation for tracheal extubation are as critical as the initial intubation. There are limited data on specific strategies for a planned extubation. The extent to which the difficult airway at reintubation contributes to patient morbidity is unknown. The aim of the present study was to describe the occurrence and complications of failed extubation and associated risk factors, and to estimate the mortality and morbidity associated with reintubation attempts. METHODS: Cohort study of 2,007 critically ill adult patients admitted to the ICU with an ETT. Patients were classified in 2 groups, based on the requirement for reintubation: "never reintubated" versus "> 1 reintubations." Baseline characteristics, ICU and hospital stay, hospital mortality, and in-patient costs were compared between patients successfully extubated and those with reintubation outside the operating room, using regression techniques. Reasons, airway management techniques, and complications of intubation and reintubation were summarized descriptively. RESULTS: 376 patients (19%) required reintubation, and 230 (11%) were reintubated within 48 hours, primarily due to respiratory failure. Patients requiring reintubation were older, more likely to be male, and had higher admission severity score. Difficult intubation and complications were similar for initial and subsequent intubation. Reintubation was associated with a 5-fold increase in the relative odds of death (adjusted odds ratio 5.86, 95% CI 3.878.89, P

KW - Airway management

KW - Cohort study

KW - Extubation

KW - ICU

KW - Mechanical ventilation

UR - http://www.scopus.com/inward/record.url?scp=84867053094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867053094&partnerID=8YFLogxK

U2 - 10.4187/respcare.01617

DO - 10.4187/respcare.01617

M3 - Article

VL - 57

SP - 1555

EP - 1563

JO - Respiratory Care

JF - Respiratory Care

SN - 0020-1324

IS - 10

ER -