Extubation in neurocritical patients with acute brain injuries, narrative review of the literature
DOI:
https://doi.org/10.17533/udea.iatreia.180Keywords:
Airway Extubation, Brain Injuries, Traumatic, Critical Care, Neurologic Manifestations, WeaningAbstract
Introduction: Ventilator weaning and extubation in patients with acute brain injuries pose a challenge for healthcare professionals due to the lack of clear consensus on extubation criteria.
Objective: To summarize the available evidence on extubation of patients with acute brain injuries and analyze potential alternatives to the classical
extubation criteria.
Methods: A literature search was conducted in the Spanish and English languages, covering the last 20 years, across different databases. Systematic
reviews with or without meta-analysis, guidelines and recommendations from scientific societies, clinical trials, and observational studies that met
the inclusion criteria were included.
Results: A total of 262 relevant articles were collected, of which, through analysis and comparison of the evidence, 48 articles were selected as most relevant to fulfill the stated objective.
Conclusions: The available evidence is weak in providing a recommendation on extubation criteria for neurocritical patients. Early extubation could be considered in patients with a minimal level of consciousness while maintaining protective airway reflexes, without an increase in reintubation rate or mortality.
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References
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