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Predictors of extubation failure in neurocritical patients: A systematic review

Published:February 21, 2022DOI:https://doi.org/10.1016/j.aucc.2021.11.005

      Abstract

      Objective

      The objective of this study was to identify predictors of extubation failure in neurocritical patients.

      Methods

      This was systematic review performed through a bibliographic search of the databases PubMed/Medline, Lilacs, SciELO, and Web of Science, from February 2020 to October 2021. Cohort studies that investigated the predictors of extubation failure were included, defined as the need for reintubation within 48 h after extubation, in adult neurocritical patients. The risk-of-bias assessment was performed using the Newcastle–Ottawa Scale, for cohort studies.

      Results

      Eight studies, totaling 18 487 participants, were included. A total of 15 predictors for extubation failure in neurocritical patients have been identified. Of these, four were the most frequent: low score on the Glasgow Coma Scale (motor score ≤5, 8T–10T), female gender, time on mechanical ventilation (≥7 days, ≥ 10 days), and moderate or large secretion volume.

      Conclusions

      In addition to the conventional parameters of weaning and extubation, other factors, such as a low score on the Glasgow Coma Scale, female gender, mechanical ventilation time, and moderate or large secretion volume, must be taken into account to prevent extubation failure in neurocritical patients in clinical practice.

      Keywords

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