Extubation timing and risk of extubation failure in aneurysmal subarachnoid hemorrhage patients

Bibliographic Details
Title: Extubation timing and risk of extubation failure in aneurysmal subarachnoid hemorrhage patients
Authors: Jun Yang, Junlin Lu, Runting Li, Fa Lin, Yu Chen, Heze Han, Ruinan Li, Zhipeng Li, Haibin Zhang, Kexin Yuan, Hongliang Li, Linlin Zhang, Guangzhi Shi, Shuo Wang, Xiaolin Chen
Source: Chinese Neurosurgical Journal, Vol 10, Iss 1, Pp 1-9 (2024)
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Surgery
LCC:Neurology. Diseases of the nervous system
Subject Terms: Aneurysmal subarachnoid hemorrhage, Extubation failure, Delayed cerebral ischemia, Microsurgery, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
More Details: Abstract Background The extubation time is critical during the intensive care unit stay in aneurysmal subarachnoid hemorrhage (aSAH) patients. The current conventional parameters for predicting extubation failure (EF) and extubation time may not be suitable for this population. Here, we aimed to identify factors associated with EF in aSAH patients. Methods From a single-center observational study on aSAH patients with computed tomography angiography from 2019 to 2021, patients who received microsurgery were enrolled and divided into two groups according to whether EF occurred. Multivariable logistic regression was conducted to evaluate disease severity, medical history, and extubation time differences between patients with and without EF. Results Of 335 patients included, EF occurred with a rate of 0.14. Delayed cerebral ischemia (67.4% vs. 13.5%) and acute hydrocephalus (6.5% vs. 1.4%) were frequently observed in patients with EF. Also, patients who develop EF presented higher disability (65.9% vs. 17.4%) and mortality (10.9% vs. 0.7%) rates. Multivariable analysis demonstrated that age (OR 1.038; 95% CI 1.004–1.073; P = 0.028), onset to admission time (OR 0.731; 95% CI 0.566–0.943; p = 0.016), WFNS grade > 3 (OR 4.309; 95% CI 1.639–11.330; p = 0.003), and extubation time 3 have a high risk of developing EF, which is amplified by the ultra-early extubation. Moreover, in patients with two or more risk factors, a prolonged intubation recommendation requires consideration to avoid the EF.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2057-4967
Relation: https://doaj.org/toc/2057-4967
DOI: 10.1186/s41016-024-00384-1
Access URL: https://doaj.org/article/14a2f74ec1754bd091bb73362db4a869
Accession Number: edsdoj.14a2f74ec1754bd091bb73362db4a869
Database: Directory of Open Access Journals
More Details
ISSN:20574967
DOI:10.1186/s41016-024-00384-1
Published in:Chinese Neurosurgical Journal
Language:English