Extubation failure

Q: Inability to complete which four commands found to be associated with increased risk of extubation failure?

Answer: At least one study showed that failure to complete all of the following commands is associated with the extubation failure. Although study was small with only 88 patients, and needs reproducibility in a bigger trial.

• open eyes, 
• follow object with eyes, 
• grasp hand, and 
• stick out tongue

Patients who failed to complete all of the four commands were more than four times as likely to fail as those who completed all the four commands.

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References:

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