PMID: 15250233Jul 15, 2004Paper

Extubation failure in the elderly

Respiratory Medicine
Ali A El SolhEileen Berbary

Abstract

To determine the causes, risk factors and complications of planned extubation failure of critically ill elderly patients, we conducted a prospective study of 175 consecutive patients (> or = 70 years old) admitted with respiratory failure. Thirty-six (21%) failed extubation within 72 h after planned extubation. Compared to a younger age group (< 70 years old) matched for severity of illness, inability to handle secretions (20%) was the most common reason of airway causes leading to extubation failure in the elderly while upper airway obstruction (22%) was the predominant cause in the control group. As for nonairway causes, COPD related hypercapnic respiratory failure accounted for the majority of cases in both groups. After adjusting for severity of illness, elderly patients who required reintubation had a higher risk of developing nosocomial pneumonia. The presence of underlying pulmonary disease (odds ratio (OR), 2.9; 95% confidence interval (CI) 1.2-6.9), length of intubation > 4 days (OR, 4.3; 95% CI 1.8-10.2), and albumin levels < 2.5 g/dl (OR, 2.7; 95% CI 1.2-6.7) were independently associated with extubation failure in the old. Objective measurements of cough strength and secretion volume are needed to reduce the morbidi...Continue Reading

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Citations

Apr 9, 2009·Intensive Care Medicine·John McCaffreyAnthony P Delaney
Jul 17, 2015·Journal of Physical Therapy Science·Camilo CorbelliniSilvia Regina Rios Vieira
Oct 31, 2007·Clinics in Chest Medicine·Jonathan M Siner, Margaret A Pisani
Nov 11, 2006·Journal of Intensive Care Medicine·Ali A El Solh, Fadi H Ramadan
Sep 3, 2011·Journal of Intensive Care Medicine·Khaldoun FarisSpiro Spanakis
Oct 2, 2015·Quality Management in Health Care·Nopakoon NantsupawatKenneth Nugent
Aug 28, 2010·Critical Care Medicine·Jay Menaker, Thomas M Scalea
Apr 13, 2017·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Eric Shih Hsiung LeeAddy Yong Hui Tan
Nov 21, 2018·PloS One·Raveewan SuraseranivongYuda Sutherasan
Apr 9, 2005·Current Opinion in Pulmonary Medicine·Michael Jan Shaw
May 1, 2019·Journal of Cardiovascular Development and Disease·Jennifer L RodgersSiva K Panguluri

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