Procedural guidelines for endotracheal extubation: insights from a narrative review

Endotracheal extubation guidelines

Abstract

Background and purpose: Operating rooms (ORs) and intensive care units (ICUs) are two most common medical environments where endotracheal extubation is conducted. The goal of this publication is to investigate the prevalence, causes, and risk factors of endotracheal extubation and to present current guidelines and protocols for performing safe endotracheal extubation of patients.

Materials and methods: A narrative review of guidelines related to endotracheal extubation of patients.

Results: Coughing and temporary hypertension are minor side effects of endotracheal extubation. With a mortality rate of about 5%, significant complications, such as extubation failure requiring reintubation, pose serious dangers. Inadequate communication between medical personnel, a lack of backup plans, and certain surgical procedures, especially those involving head and neck surgery, are factors that contribute to extubation failure. Reintubation occurs in 0.1% to 25.7% of cases. Patient features that may impact the outcome of extubation and additional extubation issues include obesity, obstructive sleep apnea, and other comorbidities. The endotracheal extubation method can be improved, and the incidence of post-extubation complications can be minimised to the greatest extent possible by implementing thorough standards and protocols to ensure safe extubation practices, especially for patients undergoing complex surgical operations.

Conclusion: the approach to each endotracheal extubation should be carefully planned and personalised. Many measures can help avoid complications from endotracheal extubation. As advances in airway management continue to evolve, future research and guideline development should prioritise the integration of new technologies in medicine.