180 patients were initially included in the study, with 105 remaining once exclusion criteria had been applied. There were a total of 141 extubations with a failure rate of 38%. Those in the ´failure´ group had a median length of ICU stay of 14.9 days vs. 8.2 days in the ´success´ group. The ICU mortality in these groups being 10% vs 8% respectively.
In relation to risk factors for extubation failure, there were no clinically significant differences between the ´failure´ and ´success´ groups in terms of: age (58 vs 57 yrs); duration of IPPV (3.3 vs 4 days); fluid balance (+ve 2047 vs 2386 mls.); RSBI (50 vs 36) and APACHE II scores (15 vs 17) respectively. However, 90% of patients with a RSBI >100 immediately prior to extubation did subsequently require reintubation.
Emergency non-invasive ventilation was commenced in 10% of patients post extubation, with 70% subsequently requiring reintubation. The reasons for extubation failure were difficult to determine, but upper airway obstruction was documented as a contributing factor in 19% of failed extubations.