Clinical interventions in aging · 2026
Clinical Characteristics and Outcomes of Non-Invasive Ventilation Following Unplanned Extubation in the Elderly ICU Patients: A Retrospective Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hsu Yi-Chen, Chen Hsing-Chun, Li Hsin-Hsien
Аннотация
BACKGROUND: Unplanned extubation (UE) is a critical adverse event in mechanically ventilated patients in the intensive care unit (ICU). Non-invasive ventilation (NIV) has been used to manage post-extubation respiratory complications; however, evidence regarding its role after UE, particularly in elderly patients, remains limited. This study aimed to characterize NIV use and explore its association with clinical outcomes in elderly ICU patients following UE.
METHODS: We conducted a retrospective cohort study of UE events in a mixed medical-surgical ICU between 2017 and 2022. Adult patients who experienced UE were included, whereas patients with long-term tracheostomy were excluded. Demographic characteristics, ventilatory conditions, NIV use, and clinical outcomes were analyzed. Multivariable logistic regression was performed to identify factors independently associated with UE failure.
RESULTS: A total of 91 UE events were identified. The mean age was 66.3 ± 16.6 years, and 51 patients (56.0%) were elderly. Medical indication for mechanical ventilation (MV) (OR 2.66, 95% CI 1.02-6.94) and higher positive end-expiratory pressure (PEEP) levels (OR 1.36, 95% CI 1.01-1.83) were independently associated with UE failure. Among elderly patients, 13 (25.5%) received NIV after UE. No significant differences were observed in re-intubation rate, duration of mechanical ventilation, or ICU length of stay between elderly patients managed with and without NIV. Findings from the NIV subgroup should be interpreted descriptively because of the limited sample size.
CONCLUSION: Medical admission diagnoses and higher PEEP levels were independently associated with UE failure. Among elderly patients, no clear differences in clinical outcomes were observed between those managed with and without NIV following UE. However, the small NIV subgroup limited definitive conclusions regarding its effectiveness. The role of NIV following UE in elderly ICU patients therefore remains uncertain.
METHODS: We conducted a retrospective cohort study of UE events in a mixed medical-surgical ICU between 2017 and 2022. Adult patients who experienced UE were included, whereas patients with long-term tracheostomy were excluded. Demographic characteristics, ventilatory conditions, NIV use, and clinical outcomes were analyzed. Multivariable logistic regression was performed to identify factors independently associated with UE failure.
RESULTS: A total of 91 UE events were identified. The mean age was 66.3 ± 16.6 years, and 51 patients (56.0%) were elderly. Medical indication for mechanical ventilation (MV) (OR 2.66, 95% CI 1.02-6.94) and higher positive end-expiratory pressure (PEEP) levels (OR 1.36, 95% CI 1.01-1.83) were independently associated with UE failure. Among elderly patients, 13 (25.5%) received NIV after UE. No significant differences were observed in re-intubation rate, duration of mechanical ventilation, or ICU length of stay between elderly patients managed with and without NIV. Findings from the NIV subgroup should be interpreted descriptively because of the limited sample size.
CONCLUSION: Medical admission diagnoses and higher PEEP levels were independently associated with UE failure. Among elderly patients, no clear differences in clinical outcomes were observed between those managed with and without NIV following UE. However, the small NIV subgroup limited definitive conclusions regarding its effectiveness. The role of NIV following UE in elderly ICU patients therefore remains uncertain.