{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:02:34Z","timestamp":1790060554197,"version":"4.0.1"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Weaning and extubation in neurocritical care are high \u2010 risk decisions complicated by impaired consciousness and airway \u2010 protection challenges and practice guidance remains fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To map, evaluate and synthesize the available evidence on weaning and extubation management for neurocritical care patients receiving mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This study was designed as an evidence summary and conducted according to the methodological standards for evidence summaries established by the Fudan University Evidence \u2010 Based Nursing Center. Twenty \u2010 seven information sources were searched from inception to 7 June 2025, including clinical decision support systems, guideline repositories, professional association websites, evidence\u2010based practice platforms and speciality databases. Eligible evidence included guidelines\/manuals, evidence summaries, expert consensus, systematic reviews and randomized controlled trials. The evidence summary was registered with the Fudan University Evidence \u2010 Based Nursing Center and guided by the 6S evidence pyramid. Quality appraisal, evidence extraction, synthesis and grading were conducted using evidence type\u2010specific tools and a pre\u2010established evidence grading system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen studies met the inclusion criteria and quality requirements. Thirty \u2010 two pieces of evidence were synthesized into six domains: functional rehabilitation and training interventions; airway protection and secretion management; swallowing and phonation training; weaning\/extubation decision \u2010 making and peri \u2010 extubation management; sedation management and consciousness support; and risk factors and predictors of extubation failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study consolidated 32 pieces of evidence on weaning and extubation in neurocritical care, providing a structured synthesis while highlighting uneven evidence quality and uncertain feasibility in resource \u2010 limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Clinicians should prioritize positioning, early rehabilitation, artificial airway management and secretion clearance, while combining evidence with expert consensus and tailoring implementation to patient status and local resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70670","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:23:18Z","timestamp":1788495798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Best Available Evidence on Weaning and Extubation in Mechanically Ventilated Neurocritical Care Patients: An Evidence Summary"],"prefix":"10.1111","volume":"31","author":[{"given":"Yuezhen","family":"Hong","sequence":"first","affiliation":[{"name":"School of Nursing Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5123-1890","authenticated-orcid":false,"given":"Meixin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fujian Institute of Brain Disorders and Brain Science, and Fujian Clinical Research Center for Neurological Diseases First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Department of Neurosurgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2010-8188","authenticated-orcid":false,"given":"Rachel H. 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