Incidence of extubation failure and its predictors among adult patients in intensive care unit of low-resource setting: A prospective observational study

Previous studies have found an association between various predictors and extubation failure (EF) in intensive care units (ICUs). However, this problem remains unexplored in low-resource settings, where predicting the extubation outcomes are more challenging. This study investigates the incidence of...

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Bibliographic Details
Published in:	PloS one Vol. 17; no. 11; p. e0277915
Main Authors:	Kifle, Natnael, Zewdu, Dereje, Abebe, Bisrat, Tantu, Temesgen, Wondwosen, Mekete, Hailu, Yirgalem, Bekele, Girma, Woldetensay, Meron
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 17-11-2022 Public Library of Science (PLoS)
Subjects:	Adult Age Airway Extubation Anesthesia Biology and Life Sciences Blood pressure Clinical trials Confidence intervals Critical care Decision making Engineering and Technology Extubation Failure analysis Family physicians Health risks Hemodynamics Hospitals Humans Incidence Intensive care Intensive Care Units Laboratories Mechanical ventilation Medical records Medicine and Health Sciences Middle Aged Mortality Nurses Observational studies Ostomy Oxygen saturation Patients Physical Sciences Pneumonia Pulse oximetry Regression analysis Respiration, Artificial Secretions Statistical analysis Suctioning Ventilation Ventilator Weaning Ventilators Weaning
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Summary:	Previous studies have found an association between various predictors and extubation failure (EF) in intensive care units (ICUs). However, this problem remains unexplored in low-resource settings, where predicting the extubation outcomes are more challenging. This study investigates the incidence of EF and its predictors among patients who received mechanical ventilation (MV). This is a prospective observational study of 123 patients' ≥ 18 years of age receiving MV for ≥ 48 hours and tolerated spontaneous breathing trials (SBTs) in the ICU of a low-resource setting. We collected data on the baseline characteristics and clinical profiles before and after SBTs. Patients were categorized into extubation failure (EF) and extubation success (ES) groups. Multivariate logistic regression analyses were performed to identify independent predictors for EF. A p-value < 0.05 is considered statistically significant. We included 123 patients, and 42 (34.15%) had developed EF. The identified predictors for EF: Moderate to copious secretions (adjusted odds ratio [AOR]: 3.483 [95% confidence interval [CI] 1.10-11.4]), age > 60 years of age ([AOR]: 4.157 [95% CI 1.38-12.48]), and prolonged duration of MV ≥ 10 days ([AOR]: 4.77 [95% CI 1.55-14.66]). Moderate to copious secretions, patients > 60 years of age, and prolonged duration of MV ≥ 10 days were the best predictors of EF. Based on our findings, we recommend that the identified predictors could help in the decision-making process of extubation from MV.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 TT, MW, YH, GB and MW also contributed equally to this work. Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0277915