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The need for reintubation within 24 72 hours of planned extubation is an event occurring in 2 25% of extubated patients [ 1].
Failed extubation was defined as the need for reintubation within 5 days of planned extubation.
Unsuccessful extubation (the need for reintubation) occurs in up to 20% of patients within 24 72 hours of planned extubation.
Extubation failure is defined by most clinicians and researchers as the need to reinstate mechanical ventilation within 24 to 72 hours of planned extubation [ 25- 29].
Of the 885 intubations, 597 (67 %) were performed due to acute respiratory failure, 241 (27 %) due to coma and 148 (17 %) due to failure of planned extubation.
Failed extubation (FE), defined as reintubation within 48 hours of planned extubation (PE), is common.
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The rates vary widely in part because of differences in the diagnostic categories of the patients studied, the duration of mechanical ventilation prior to planned extubation, and the interventions that were assessed.
It might be argued that the use of corticosteroids in adult critical care for planned extubation is unnecessary, because objectively the incidence of reintubation is low and symptomatic laryngeal oedema has self-limited symptoms.
Many risk factors for planned extubation failure have been suggested, including hypercapnia at end of spontaneous breathing trial (SBT).
Our results confirm the benefit of multidose steroids before planned extubation of adults.
Further trials are needed to establish the optimal dose of steroids and the optimal time between the start of treatment and planned extubation.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com