PLoS ONE (Jan 2023)

Association of immediate versus delayed extubation of patients admitted to intensive care units postoperatively and outcomes: A retrospective study.

  • Paul Zajic,
  • Michael Eichinger,
  • Michael Eichlseder,
  • Barbara Hallmann,
  • Gabriel Honnef,
  • Tobias Fellinger,
  • Barbara Metnitz,
  • Martin Posch,
  • Martin Rief,
  • Philipp G H Metnitz

DOI
https://doi.org/10.1371/journal.pone.0280820
Journal volume & issue
Vol. 18, no. 1
p. e0280820

Abstract

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Aim of this studyThis study seeks to investigate, whether extubation of tracheally intubated patients admitted to intensive care units (ICU) postoperatively either immediately at the day of admission (day 1) or delayed at the first postoperative day (day 2) is associated with differences in outcomes.Materials and methodsWe performed a retrospective analysis of data from an Austrian ICU registry. Adult patients admitted between January 1st, 2012 and December 31st, 2019 following elective and emergency surgery, who were intubated at the day 1 and were extubated at day 1 or day 2, were included. We performed logistic regression analyses for in-hospital mortality and over-sedation or agitation following extubation.Results52 982 patients constituted the main study population. 1 231 (3.3%) patients extubated at day 1 and 958 (5.9%) at day 2 died in hospital, 464 (1.3%) patients extubated at day 1 and 613 (3.8%) at day 2 demonstrated agitation or over-sedation after extubation during ICU stay; OR (95% CI) for in-hospital mortality were OR 1.17 (1.01-1.35, p = 0.031) and OR 2.15 (1.75-2.65, pConclusionsWe conclude that immediate extubation as soon as deemed feasible by clinicians is associated with favourable outcomes and may thus be considered preferable in tracheally intubated patients admitted to ICU postoperatively.