{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:09:15Z","timestamp":1789063755274,"version":"build-2803163510"},"reference-count":19,"publisher":"Canadian Society of Respiratory Therapists","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Timely extubation is essential to ensure patient safety and efficient intensive care unit (ICU) management. Delays in extubation can lead to adverse outcomes and extended hospital stays. Although several factors affect timely extubation, those contributing to delays, especially in Saudi Arabian ICUs, have not been well described. This study aimed to identify factors contributing to delayed extubation in Saudi Arabian ICUs from the perspective of ICU healthcare professionals (HCPs), including physicians, nurses, and respiratory therapists (RTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted in Saudi Arabia among physicians, respiratory therapists (RTs), and nurses with at least three months of ICU experience. The questionnaire assessed perceived extubation timing, comfort with extubation order placement, perceived barriers to delayed extubation, and suggested solutions. Likert-scale items were interpreted as perceived barrier scores, with higher scores indicating stronger perceived barriers to delay. Open-ended responses were analyzed using Braun and Clarke\u2019s thematic analysis framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 292 ICU professionals participated in the study (22% physicians, 31% nurses, and 45% RTs). Although most respondents (78%) reported that extubation usually occurred within 3 hours of a successful spontaneous breathing trial (SBT), their perceptions of the appropriateness of this timing differed. The most frequently reported barriers to timely extubation were staffing limitations (18%), communication and teamwork issues (16%), and procedural inefficiencies (14%). Physician comfort levels with placing extubation orders varied significantly by seniority (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). Suggested solutions included standardized protocols (20%), adequate staffing (18%), and routine assessments (16%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICU healthcare professionals perceived delayed extubation as mainly associated with modifiable organizational and workflow-related barriers. Addressing these barriers through interprofessional collaboration, protocol standardization, and targeted training may optimize the extubation process and ultimately may inform future quality improvement initiatives in Saudi ICUs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.29390\/001c.169500","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:48:16Z","timestamp":1789062496000},"source":"Crossref","is-referenced-by-count":0,"title":["Perspectives of intensive care professionals on extubation practices, causes of delays, and proposed solutions: A cross-sectional study"],"prefix":"10.29390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4423-8075","authenticated-orcid":true,"given":"Ali M.","family":"Alasmari","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01xv1nn60","id-type":"ROR","asserted-by":"publisher"}],"name":"Taibah University","department":["Respiratory Therapy Department, College of Medical Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyad","family":"Alshehri","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01xv1nn60","id-type":"ROR","asserted-by":"publisher"}],"name":"Taibah University","department":["Respiratory Therapy Department, College of Medical Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haneen","family":"Alrehaili","sequence":"additional","affiliation":[{"name":"Saudi German Hospital, Madinah, Saudi Arabia","department":["Respiratory Therapy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joud","family":"Mahrous","sequence":"additional","affiliation":[{"name":"Prince Mohammed Bin Abdulaziz Hospital, Madinah, Saudi Arabia","department":["Respiratory Therapy Services"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alsaedi","sequence":"additional","affiliation":[{"name":"Madina National Hospital, Madinah, Saudi Arabia","department":["Respiratory Therapy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deemah","family":"Alahmadi","sequence":"additional","affiliation":[{"name":"Dr. Hamid Suliman Al Ahmadi Hospital, Madinah, Saudi Arabia","department":["Respiratory Therapy Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman M.","family":"Hawsawi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01xv1nn60","id-type":"ROR","asserted-by":"publisher"}],"name":"Taibah University","department":["Respiratory Therapy Department, College of Medical Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keir EJ","family":"Philip","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/041kmwe10","id-type":"ROR","asserted-by":"publisher"}],"name":"Imperial College London","department":["National Heart and Lung Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah S","family":"Alsulayyim","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02bjnq803","id-type":"ROR","asserted-by":"publisher"}],"name":"Jazan University","department":["Respiratory Therapy Program, Department of Nursing, College of Nursing and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faten S","family":"Almutairi","sequence":"additional","affiliation":[{"name":"Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia","department":["Respiratory Therapy Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemah N","family":"Alahmadi","sequence":"additional","affiliation":[{"name":"King Salman Armed Forces Hospital, Northwest Tabuk","department":["Respiratory Therapy Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad I.","family":"Alhusseini","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia","department":["Respiratory Care Services"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya A.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia","department":["Department of Respiratory Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Sobh","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01xv1nn60","id-type":"ROR","asserted-by":"publisher"}],"name":"Taibah University","department":["Respiratory Therapy Department, College of Medical Rehabilitation Sciences"]},{"id":[{"id":"https:\/\/ror.org\/03ewepe58","id-type":"ROR","asserted-by":"publisher"}],"name":"Al-Azhar University","department":["Chest Diseases Department, Faculty of Medicine for 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