{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:24:45Z","timestamp":1769153085595,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Extubation failure is associated with negative outcomes making the identification of risk factors for failure paramount. Burn patients experience a high incidence of respiratory failure requiring mechanical ventilation. There is no consensus on the acceptable rate of extubation failure and many conventional indices do not accurately predict extubation outcomes in burn patients. The purpose of this study was to examine the rate of extubation failure in the burned population and to examine the impact of factors on extubation outcomes. Burn patients from a single center over 9 years were examined and included if they were intubated prior to arrival or within 48 hours of admission and underwent a planned extubation. From this cohort, a matched case\u2013control analysis based on age, TBSA, and sex was performed of patients who succeeded after extubation, defined as not requiring reintubation within 72 hours, to those who failed. Characteristics and clinical parameters were compared to determine whether any factors could predict extubation failure. There was a 12.3% incidence of extubation failure. In the matched case\u2013control analysis, the presence of inhalation injury was associated with extubation success. Higher heart rate and lower serum pH were associated with extubation failure. ANCOVA analysis demonstrated that a sodium trending higher before extubation was associated with more successes, possibly indicative of a lower volume status. Classic extubation criteria do not accurately predict extubation outcomes in burn patients; analysis of other parameters may be able to provide better predictions. A constellation of these parameters needs to be studied prospectively.<\/jats:p>","DOI":"10.1093\/jbcr\/iraa162","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T08:54:02Z","timestamp":1599900842000},"page":"177-181","source":"Crossref","is-referenced-by-count":5,"title":["Extubation Failure in a Burn Intensive Care Unit: Examination of Contributing Factors"],"prefix":"10.1093","volume":"42","author":[{"given":"Julie A","family":"Rizzo","sequence":"first","affiliation":[{"name":"United States Army Institute of Surgical Research, Fort Sam Houston, Texas"},{"name":"Uniformed Services University of Health Sciences, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahdi","family":"Haq","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research, Fort Sam Houston, Texas"},{"name":"Metis Foundation, San Antonio Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan A","family":"McMahon","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center, Fort Sam Houston, Texas"},{"name":"United States Army Medical Center of Excellence, Joint Base San Antonio, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James K","family":"Aden","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center, Fort Sam Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel B","family":"Brillhart","sequence":"additional","affiliation":[{"name":"Darnell Army Medical Center, Fort Hood, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leopoldo C","family":"Cancio","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research, Fort Sam Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,12]]},"reference":[{"key":"2021030904542723300_CIT0001","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1097\/00003246-199311000-00016","article-title":"Mulitple organ failure in patients with thermal injury","volume":"21","author":"Saffle","year":"1993","journal-title":"Crit Care Med"},{"key":"2021030904542723300_CIT0002","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/00000658-198503000-00021","article-title":"Upper airway sequelae in burn patients requiring endotracheal intubation or tracheostomy","volume":"201","author":"Lund","year":"1985","journal-title":"Ann Surg"},{"key":"2021030904542723300_CIT0003","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1378\/chest.89.2.165","article-title":"Acute complications of endotracheal intubation","volume":"89","author":"Rashkin","year":"1986","journal-title":"Chest."},{"key":"2021030904542723300_CIT0004","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1164\/ajrccm\/139.4.877","article-title":"Nosocomial pneumonia in patients receiving continuous mechanical ventilation","volume":"139","author":"Fagon","year":"1989","journal-title":"Am Rev Respir Dis."},{"key":"2021030904542723300_CIT0005","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.burns.2008.12.005","article-title":"Evaluation of the spontaneous breathing trial in burn intensive care patients","volume":"35","author":"Smailes","year":"2009","journal-title":"Burns."},{"key":"2021030904542723300_CIT0006","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1164\/ajrccm.152.1.7599812","article-title":"Re-intubation increases the risk of nosocomial pneumonia in patients needing mechanical ventilation","volume":"152","author":"Torres","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"2021030904542723300_CIT0007","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1164\/ajrccm.158.6.9712135","article-title":"Clinical characteristics, respiratory functional parameters, and outcome of a two-hour T-piece trial in patients weaning from mechanical ventilation","volume":"158","author":"Vallverd\u00fa","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"issue":"2 Pt 1","key":"2021030904542723300_CIT0008","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1164\/ajrccm.156.2.9610109","article-title":"Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation","volume":"156","author":"Esteban","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2021030904542723300_CIT0009","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1164\/ajrccm.159.2.9803106","article-title":"Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation","volume":"159","author":"Esteban","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"key":"2021030904542723300_CIT0010","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1378\/chest.112.1.186","article-title":"Effect of failed extubation on the outcome of mechanical ventilation","volume":"112","author":"Epstein","year":"1997","journal-title":"Chest."},{"key":"2021030904542723300_CIT0011","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1056\/NEJM199105233242101","article-title":"A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation","volume":"324","author":"Yang","year":"1991","journal-title":"N Engl J Med"},{"key":"2021030904542723300_CIT0012","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00075198-200302000-00011","article-title":"Extubation failure: magnitude of the problem, impact on outcomes, and prevention","volume":"9","author":"Rothaar","year":"2003","journal-title":"Curr Opin Crit Care"},{"key":"2021030904542723300_CIT0013","first-page":"37","article-title":"Risk factors associated with early reintubation in trauma patients: a prospective observational study","volume":"71","author":"Brown","year":"2011","journal-title":"J Trauma"},{"key":"2021030904542723300_CIT0014","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/BCR.0B013E31814B25B1","article-title":"National burn repository 2006 report dataset version 3.0","volume":"28","author":"Latenser","year":"2007","journal-title":"J Burn Care Res"},{"issue":"3 Pt 1","key":"2021030904542723300_CIT0015","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00004630-199505000-00002","article-title":"Recent outcomes in the treatment of burn injury in the United States: a report from the American Burn Association Patient Registry","volume":"16","author":"Saffle","year":"1995","journal-title":"J Burn Care Rehabil"},{"key":"2021030904542723300_CIT0016","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/0002-9610(85)90415-5","article-title":"Effect of inhalation injury on fluid resuscitation requirements after thermal injury","volume":"150","author":"Navar","year":"1985","journal-title":"Am J Surg"},{"key":"2021030904542723300_CIT0017","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S0305-4179(98)00092-8","article-title":"The comparison of early fluid therapy in extensive flame burns between inhalation and noninhalation injuries","volume":"24","author":"Dai","year":"1998","journal-title":"Burns"},{"key":"2021030904542723300_CIT0018","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/01.TA.0000075341.43956.E4","article-title":"Predicting increased fluid requirements during the resuscitation of thermally injured patients","volume":"56","author":"Cancio","year":"2004","journal-title":"J Trauma"},{"key":"2021030904542723300_CIT0019","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1097\/01.BCR.0000245493.26814.CE","article-title":"Factors affecting prognosis of inhalation injury","volume":"27","author":"Edelman","year":"2006","journal-title":"J Burn Care Res"},{"key":"2021030904542723300_CIT0020","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/BCR.0B013E318031D049","article-title":"Pneumonia after inhalation injury","volume":"28","author":"Edelman","year":"2007","journal-title":"J Burn Care Res"},{"key":"2021030904542723300_CIT0021","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/BCR.0b013e3181a2894c","article-title":"The incidence and outcome of extubation failure in burn intensive care patients","volume":"30","author":"Smailes","year":"2009","journal-title":"J Burn Care Res"},{"key":"2021030904542723300_CIT0022","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.burns.2012.09.028","article-title":"Cough strength, secretions and extubation outcome in burn patients who have passed a spontaneous breathing trial","volume":"39","author":"Smailes","year":"2013","journal-title":"Burns"},{"key":"2021030904542723300_CIT0023","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1097\/00003246-198806000-00001","article-title":"Incidence and morbidity of extubation failure in surgical intensive care patients","volume":"16","author":"Demling","year":"1988","journal-title":"Crit Care Med"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/iraa162\/33979192\/iraa162.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/42\/2\/177\/36454155\/iraa162.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/42\/2\/177\/36454155\/iraa162.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T04:59:48Z","timestamp":1615265988000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/42\/2\/177\/5904507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,12]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,9,12]]},"published-print":{"date-parts":[[2021,3,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/iraa162","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2020,9,12]]}}}