{
    "abstract": "Postoperative patients constitute majority of critically ill patients, although factors predicting extubation failure in this group of patients remain unidentified. Aiming to propose clinical predictors of reintubation in postoperative patients, we conducted a post-hoc analysis of a multicenter prospective observational study.\nThis study included postoperative critically ill patients who underwent mechanical ventilation for >\u200924\u00a0h and were extubated after a successful 30-min spontaneous breathing trial. The primary outcome was reintubation within 48\u00a0h after extubation, and clinical predictors for reintubation were investigated using logistic regression analyses.\nAmong the 355 included patients, 10.7% required reintubation. Multivariable logistic regression identified that the number of endotracheal suctioning episodes during the 24\u00a0h before extubation and underlying respiratory disease or pneumonia occurrence were significantly associated with reintubation (adjusted odds ratio [OR] 1.11, 95% confidence interval [CI] 1.05-1.18, p\u2009<\u20090.001; adjusted OR 2.58, 95%CI 1.30-5.13, p\u2009=\u20090.007). The probability of reintubation was increased significantly with the higher frequency of endotracheal suctioning, as indicated by restricted cubic splines. Subgroup analysis showed that these predictors were consistently associated with reintubation regardless of the use of noninvasive respiratory support after extubation.\nEndotracheal suctioning frequency and respiratory complications were identified as independent predictors of reintubation. These readily obtainable predictors may aid in decision-making regarding the extubation of postoperative patients.",
    "authors": [
        {
            "affiliation": "Faculty of Medicine, Osaka University, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan.",
            "firstname": "Jun",
            "initials": "J",
            "lastname": "Hattori"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan. aikotanakaicu@gmail.com.\nDepartment of Intensive Care, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida, 910-1193, Fukui, Japan. aikotanakaicu@gmail.com.",
            "firstname": "Aiko",
            "initials": "A",
            "lastname": "Tanaka"
        },
        {
            "affiliation": "Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan.",
            "firstname": "Junko",
            "initials": "J",
            "lastname": "Kosaka"
        },
        {
            "affiliation": "Department of Anesthesiology, Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan.",
            "firstname": "Osamu",
            "initials": "O",
            "lastname": "Hirao"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Kobe University Hospital, 7-5-2 Kusunoki- cho, Chuo-ku, Kobe City, 650-0017, Japan.",
            "firstname": "Nana",
            "initials": "N",
            "lastname": "Furushima"
        },
        {
            "affiliation": "Department of Anesthesiology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, 153-8515, Meguro, Tokyo, Japan.",
            "firstname": "Yuichi",
            "initials": "Y",
            "lastname": "Maki"
        },
        {
            "affiliation": "Center for Mathematical and Data Science, Kobe University, 1-1 Rokkodai-cho, Nada-ku, Kobe, 657-8501, Hyogo, Japan.",
            "firstname": "Daijiro",
            "initials": "D",
            "lastname": "Kabata"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan.",
            "firstname": "Akinori",
            "initials": "A",
            "lastname": "Uchiyama"
        },
        {
            "affiliation": "Department of Anesthesia, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto, 606- 8507, Japan.",
            "firstname": "Moritoki",
            "initials": "M",
            "lastname": "Egi"
        },
        {
            "affiliation": "Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan.",
            "firstname": "Hiroshi",
            "initials": "H",
            "lastname": "Morimatsu"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Kobe University Hospital, 7-5-2 Kusunoki- cho, Chuo-ku, Kobe City, 650-0017, Japan.",
            "firstname": "Satoshi",
            "initials": "S",
            "lastname": "Mizobuchi"
        },
        {
            "affiliation": "Department of Anesthesiology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, 153-8515, Meguro, Tokyo, Japan.",
            "firstname": "Yoshifumi",
            "initials": "Y",
            "lastname": "Kotake"
        },
        {
            "affiliation": "Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.",
            "firstname": "Ayumi",
            "initials": "A",
            "lastname": "Shintani"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan.",
            "firstname": "Yukiko",
            "initials": "Y",
            "lastname": "Koyama"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan.",
            "firstname": "Takeshi",
            "initials": "T",
            "lastname": "Yoshida"
        },
        {
            "affiliation": "Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan.",
            "firstname": "Yuji",
            "initials": "Y",
            "lastname": "Fujino"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s12871-025-02996-1",
    "journal": "BMC anesthesiology",
    "keywords": [
        "Clinical predictor",
        "Critical care",
        "Endotracheal suctioning",
        "Extubation failure",
        "Postoperative patient",
        "Reintubation"
    ],
    "methods": null,
    "publication_date": "2025-03-16",
    "pubmed_id": "40089666\n21376523\n27818331\n33302267\n28288027\n38849936\n27377334\n38964674\n38772683\n23641924\n29991220\n36369190\n20841406\n31627316\n33735250\n33692291\n34127233\n37147688\n35252224\n38476061\n26556899\n27895441\n35354159\n24240985\n30742650\n25466352\n21045639\n33435881\n38720332\n22324979\n25592172\n23903264\n30167302\n35566646\n34620954\n33104823\n35078900\n17716382\n23645634\n30243304\n30017306\n30671726\n35024978\n21552116\n23711598\n35355600\n33201321\n26975498\n37019458\n31270177",
    "results": "Among the 355 included patients, 10.7% required reintubation. Multivariable logistic regression identified that the number of endotracheal suctioning episodes during the 24\u00a0h before extubation and underlying respiratory disease or pneumonia occurrence were significantly associated with reintubation (adjusted odds ratio [OR] 1.11, 95% confidence interval [CI] 1.05-1.18, p\u2009<\u20090.001; adjusted OR 2.58, 95%CI 1.30-5.13, p\u2009=\u20090.007). The probability of reintubation was increased significantly with the higher frequency of endotracheal suctioning, as indicated by restricted cubic splines. Subgroup analysis showed that these predictors were consistently associated with reintubation regardless of the use of noninvasive respiratory support after extubation.",
    "title": "Clinical predictors of extubation failure in postoperative critically ill patients: a post-hoc analysis of a multicenter prospective observational study.",
    "xml": "<Element 'PubmedArticle' at 0x788505a84590>"
}