Extubation in neurocritical care patients. the ENIO international prospective study
| Title: | Extubation in neurocritical care patients. the ENIO international prospective study |
|---|---|
| Authors: | Cinotti R.; Mijangos J. C.; Pelosi P.; Haenggi M.; Gurjar M.; Schultz M. J.; Kaye C.; Godoy D. A.; Alvarez P.; Ioakeimidou A.; Ueno Y.; Badenes R.; Suei Elbuzidi A. A.; Piagnerelli M.; Elhadi M.; Reza S. T.; Azab M. A.; McCredie V.; Stevens R. D.; Digitale J. C.; Fong N.; Asehnoune K.; Abback P. -S.; Codorniu A.; Citerio G.; Sala V. L.; Astuto M.; Tringali E.; Alampi D.; Rocco M.; Maugeri J. G.; Bellissima A.; Filippini M.; Lazzeri N.; Cortegiani A.; Ippolito M.; Robba C.; Battaglini D.; Biston P.; Al-Gharyani M. F.; Chabanne R.; Astier L.; Soyer B.; Gaugain S.; Zimmerli A.; Pietsch U.; Filipovic M.; Brandi G.; Bicciato G.; Serrano A.; Monleon B.; van Vliet P.; Gerretsen B. M.; Ortiz-Macias I. X.; Oto J.; Enomoto N.; Matsuda T.; Masui N.; Garcon P.; Zarka J.; Vermeijden W. J.; Cornet A. D.; Inurrigarro S. R.; Dominguez R. C. L.; Bellini M. M.; Haedo M. M. G.; Lamot L.; Orquera J.; Biais M.; Georges D.; Baronia A.; Miranda-Ackerman R. C.; Barbosa-Camacho F. J.; Porter J.; Lopez-Morales M.; Geeraerts T.; Compagnon B.; Perez-Torres D.; Prol-Silva E.; Yahya H. B.; Khaled A.; Ghula M.; Andrea C. N.; Daniela P. M.; Deana C.; Vetrugno L.; Chavez M. J. R.; Trujillo R. M.; Legros V.; Brochet B.; Huet O.; Geslain M.; van der Jagt M.; van Steenkiste J.; Ahmed H.; Coombs A. E.; Welbourne J.; Pineda A. A. V.; Castillo V. H. N.; Azzam A. Y.; van Meenen D. M. P.; Gasca G. A.; Arellano A.; Galicia-Espinosa F.; Garcia-Ramos J. C.; Yadav G.; Jha A. K.; Robert-Edan V.; Rodie-Talbere P. -A.; Jain G.; Panda S.; Agarwal S.; Deewan Y.; Hossain M. M.; Papadas C.; Chantziara V.; Sklavou C.; Hourmant Y.; Grillot N.; Pirracchio R.; Akkari A.; Abdelaty M.; Hashim A.; Launey Y.; Masseret E.; Lasocki S.; Gergaud S.; Mouclier N.; Saxena S.; Agrawal A.; Mishra S. B.; Samal S. |
| Contributors: | Cinotti, R.; Mijangos, J. C.; Pelosi, P.; Haenggi, M.; Gurjar, M.; Schultz, M. J.; Kaye, C.; Godoy, D. A.; Alvarez, P.; Ioakeimidou, A.; Ueno, Y.; Badenes, R.; Suei Elbuzidi, A. A.; Piagnerelli, M.; Elhadi, M.; Reza, S. T.; Azab, M. A.; Mccredie, V.; Stevens, R. D.; Digitale, J. C.; Fong, N.; Asehnoune, K.; Abback, P. -S.; Codorniu, A.; Citerio, G.; Sala, V. L.; Astuto, M.; Tringali, E.; Alampi, D.; Rocco, M.; Maugeri, J. G.; Bellissima, A.; Filippini, M.; Lazzeri, N.; Cortegiani, A.; Ippolito, M.; Robba, C.; Battaglini, D.; Biston, P.; Al-Gharyani, M. F.; Chabanne, R.; Astier, L.; Soyer, B.; Gaugain, S.; Zimmerli, A.; Pietsch, U.; Filipovic, M.; Brandi, G.; Bicciato, G.; Serrano, A.; Monleon, B.; van Vliet, P.; Gerretsen, B. M.; Ortiz-Macias, I. X.; Oto, J.; Enomoto, N.; Matsuda, T.; Masui, N.; Garcon, P.; Zarka, J.; Vermeijden, W. J.; Cornet, A. D.; Inurrigarro, S. R.; Dominguez, R. C. L.; Bellini, M. M.; Haedo, M. M. G.; Lamot, L.; Orquera, J.; Biais, M.; Georges, D.; Baronia, A.; Miranda-Ackerman, R. C.; Barbosa-Camacho, F. J.; Porter, J.; Lopez-Morales, M.; Geeraerts, T.; Compagnon, B.; Perez-Torres, D.; Prol-Silva, E.; Yahya, H. B.; Khaled, A.; Ghula, M.; Andrea, C. N.; Daniela, P. M.; Deana, C.; Vetrugno, L.; Chavez, M. J. R.; Trujillo, R. M.; Legros, V.; Brochet, B.; Huet, O.; Geslain, M.; van der Jagt, M.; van Steenkiste, J.; Ahmed, H.; Coombs, A. E.; Welbourne, J.; Pineda, A. A. V.; Castillo, V. H. N. |
| Publisher Information: | Springer |
| Publication Year: | 2022 |
| Collection: | Sapienza Università di Roma: CINECA IRIS |
| Subject Terms: | brain injury; extubation; intra-cranial haemorrhage; tracheostomy; traumatic brain injury |
| Description: | Purpose: Neurocritical care patients receive prolonged invasive mechanical ventilation (IMV), but there is poor specific information in this high-risk population about the liberation strategies of invasive mechanical ventilation. Methods: ENIO (NCT03400904) is an international, prospective observational study, in 73 intensive care units (ICUs) in 18 countries from 2018 to 2020. Neurocritical care patients with a Glasgow Coma Score (GCS) ≤ 12, receiving IMV ≥ 24h, undergoing extubation attempt or tracheostomy were included. The primary endpoint was extubation failure by day 5. An extubation success prediction score was created, with 2/3 of patients randomly allocated to the training cohort and 1/3 to the validation cohort. Secondary endpoints were the duration of IMV and in-ICU mortality. Results: 1512 patients were included. Among the 1193 (78.9%) patients who underwent an extubation attempt, 231 (19.4%) failures were recorded. The score for successful extubation prediction retained 20 variables as independent predictors. The area under the curve (AUC) in the training cohort was 0.79 95% confidence interval (CI95) [0.71-0.87] and 0.71 CI95 [0.61-0.81] in the validation cohort. Patients with extubation failure displayed a longer IMV duration (14 [7-21] vs 6 [3-11] days) and a higher in-ICU mortality rate (8.7% vs 2.4%). Three hundred and nineteen (21.1%) patients underwent tracheostomy without extubation attempt. Patients with direct tracheostomy displayed a longer duration of IMV and higher in-ICU mortality than patients with an extubation attempt (success and failure). Conclusions: In neurocritical care patients, extubation failure is high and is associated with unfavourable outcomes. A score could predict extubation success in multiple settings. However, it will be mandatory to validate our findings in another prospective independent cohort. |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/36038713; info:eu-repo/semantics/altIdentifier/wos/WOS:000847261700004; volume:48; issue:11; firstpage:1539; lastpage:1550; numberofpages:12; journal:INTENSIVE CARE MEDICINE; https://hdl.handle.net/11573/1675338 |
| DOI: | 10.1007/s00134-022-06825-8 |
| Availability: | https://hdl.handle.net/11573/1675338; https://doi.org/10.1007/s00134-022-06825-8 |
| Rights: | info:eu-repo/semantics/closedAccess |
| Accession Number: | edsbas.B69B69B7 |
| Database: | BASE |