Prevalence of extubation and associated risk factors at a tertiary care pediatric intensive care unit.
INTRODUCTION
Extubation failure (EF) is associated with a higher risk for pneumonia, hospital stay, and mortality.


OBJECTIVE
To determine the prevalence of EF and identify the associated factors in our population.


MATERIALS AND METHODS
Observational and retrospective design. All patients aged 1 month old to 18 years old who required mechanical ventilation for more than 12 hours and underwent at least one scheduled extubation during their stay in the 2012-2016 period were included. The aspects related to ventilation and the causes of failure were recorded.


RESULTS
Seven hundred and thirty-one patients were extubated and the prevalence of EF was 19.3 %. The causes of failure included upper airway obstruction (51.4 %), muscle fatigue (20.1 %), respiratory center depression (14.6 %), and inability to protect the airways (9.7 %). As per the multivariate analysis, the independent factors that accounted for EF were neurological complex chronic condition (odds ratio [OR] = 2.27; 95 % confidence interval [CI] = 1.21-4.26); acute lower respiratory tract infection in a patient with prior sequelae (OR = 1.87, 95 % CI = 1.113.15); acute neurological injury (OR = 1.92, 95 % CI = 1.03-3.57); unplanned extubation (OR = 2.52, 95 % CI = 1.02-6.21), and presence of stridor (OR = 5.84, 95 % CI = 3.66-9.31).


CONCLUSION
The main cause of EF was upper airway obstruction. Neurological sequelae, acute neurological injury, unplanned extubation, and the presence of postextubation stridor were identified as risk factors associated with EF.
['Simonassi|Julia|J|', 'Bonora Sanso|Juan P|JP|']
D000293:Adolescent D060666:Airway Extubation D000402:Airway Obstruction D002648:Child D002675:Child, Preschool D005260:Female D006801:Humans D007223:Infant D015278:Intensive Care Units, Pediatric D007442:Intubation, Intratracheal D007902:Length of Stay D008297:Male D015995:Prevalence D012121:Respiration, Artificial D012131:Respiratory Insufficiency D012189:Retrospective Studies D012307:Risk Factors D063128:Tertiary Healthcare
Upper airway obstruction Mechanical ventilation disconnection Tracheal extubation