Q: All of the following are predictors of failed extubation except?

A) Weak cough strength 
B) Glasgow Coma Score less than 8
C) Suctioning every four hours 
D) Reduced cuff leak
E) Presence of NG tube


Answer: C

The Objective of above question is to signify the importance of increase secretions in predictors of failed extubation. If the patient requires suctioning every two to three hours, extubation should be delayed and cause for increase secretions should be sought and corrected. As a guideline, if sputum volume is more than 2.5 mL/hr, it should be a concern. Other predictors of probable fail extubation are weak cough strength, Glasgow Coma Score less than 8, reduced cuff leak, presence of OG/NG tube, prolonged intubation or traumatic intubation, the larger size of ETT and few other clinical scenarios.


Reference:

Salam A, Tilluckdharry L, Amoateng-Adjepong Y, Manthous CA. Neurologic status, cough, secretions and extubation outcomes. Intensive Care Med 2004; 30:1334.