Observational studyCritical care (London, England)2018
Risk factors and outcomes for airway failure versus non-airway failure in the intensive care unit: a multicenter observational study of 1514 extubation procedures.
Observational study in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05635903 (Can Continuous or Intermittent Normal Saline Nebulisation Via a Vibrating Mesh Nebuliser or Intermittent Normal Saline Via a Standard Jet Nebuliser Improve the Lung Physiology and Secretion Viscosity in Mechanically Ventilated Patients?), which is not on this map. Cited by 84 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Can Continuous or Intermittent Normal Saline Nebulisation Via a Vibrating Mesh Nebuliser or Intermittent Normal Saline Via a Standard Jet Nebuliser Improve the Lung Physiology and Secretion Viscosity in Mechanically Ventilated Patients?
Who cites it
84 citing papers in PubMed, 6 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Handgrip strength association with weaning outcome in mechanically ventilated ICU patients: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Risk Factors for Post-operative Planned Reintubation in Patients After General Anesthesia: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Prediction of extubation outcome in critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2021Pooled it
- Predictive power of extubation failure diagnosed by cough strength: a systematic review and meta-analysis.Critical care (London, England) · 2021Pooled it
- Comparison of T-piece and pressure support ventilation as spontaneous breathing trials in critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2020Pooled it
- Effect of the extubation predictive score (ExPreS) on reintubation in the ICU: a randomized controlled trial.Critical care (London, England) · 2026Trial
- Spontaneous breathing trials should be adapted for each patient according to the critical illness. A new individualised approach: the GLOBAL WEAN study.Intensive care medicine · 2024Trial
- Noninvasive ventilation on reintubation in patients with obesity and hypoxemic respiratory failure following abdominal surgery: a post hoc analysis of a randomized clinical trial.Intensive care medicine · 2024Trial
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- Effects of mechanical in-exsufflation in preventing postextubation acute respiratory failure in intensive care acquired weakness patients: a randomized controlled trial.Critical care scienceTrial
- Aligning prediction targets before ranking diaphragm ultrasound parameters in AECOPD.Critical care (London, England) · 2026Article
- Prophylactic NIV after extubation in non-hypercapnic high-risk patients: moving beyond convenience toward clinical benefit.Intensive care medicine · 2026Article
- Rethinking extubation readiness in the neurocritical patient: from respiratory load to airway protection.Intensive care medicine · 2026Article
- Spontaneous breathing trials as predictors of extubation outcomes in neurocritical care: insights from the ENIO study.Intensive care medicine · 2026Observational
- Diagnostic accuracy of tests for assessing readiness for liberation from mechanical ventilation in adults: an overview of reviews.Journal of intensive care · 2026Review
- Characterization of weaning practices in intensive care units in Global South countries: a clinical practice survey.Critical care science · 2026Article
- Risk Factors and Outcomes of Reintubation Following Combined Heart-Lung Transplantation.Clinical transplantation · 2026Article
- Ventilator Settings and Monitoring Variables Associated with Extubation Failure in Critically Ill Patients: A Retrospective Cohort Study.Critical care science · 2026Observational
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 16 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients liberated from invasive mechanical ventilation are at risk of extubation failure, including inability to breathe without a tracheal tube (airway failure) or without mechanical ventilation (non-airway failure). We sought to identify respective risk factors for airway failure and non-airway failure following extubation.
methodsThe primary endpoint of this prospective, observational, multicenter study in 26 intensive care units was extubation failure, defined as need for reintubation within 48 h following extubation. A multinomial logistic regression model was used to identify risk factors for airway failure and non-airway failure.
resultsBetween 1 December 2013 and 1 May 2015, 1514 patients undergoing extubation were enrolled. The extubation-failure rate was 10.4% (157/1514), including 70/157 (45%) airway failures, 78/157 (50%) non-airway failures, and 9/157 (5%) mixed airway and non-airway failures. By multivariable analysis, risk factors for extubation failure were either common to airway failure and non-airway failure: intubation for coma (OR 4.979 (2.797-8.864), P < 0.0001 and OR 2.067 (1.217-3.510), P = 0.003, respectively, intubation for acute respiratory failure (OR 3.395 (1.877-6.138), P < 0.0001 and OR 2.067 (1.217-3.510), P = 0.007, respectively, absence of strong cough (OR 1.876 (1.047-3.362), P = 0.03 and OR 3.240 (1.786-5.879), P = 0.0001, respectively, or specific to each specific mechanism: female gender (OR 2.024 (1.187-3.450), P = 0.01), length of ventilation > 8 days (OR 1.956 (1.087-3.518), P = 0.025), copious secretions (OR 4.066 (2.268-7.292), P < 0.0001) were specific to airway failure, whereas non-obese status (OR 2.153 (1.052-4.408), P = 0.036) and sequential organ failure assessment (SOFA) score ≥ 8 (OR 1.848 (1.100-3.105), P = 0.02) were specific to non-airway failure. Both airway failure and non-airway failure were associated with ICU mortality (20% and 22%, respectively, as compared to 6% in patients with extubation success, P < 0.0001).
conclusionsSpecific risk factors have been identified, allowing us to distinguish between risk of airway failure and non-airway failure. The two conditions will be managed differently, both for prevention and curative strategies.
trial registrationClinicalTrials.gov, NCT 02450669 . Registered on 21 May 2015.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.