Extubation in neurocritical care patients: the ENIO international prospective study
Issued Date
2022-11-01
Resource Type
ISSN
03424642
eISSN
14321238
Scopus ID
2-s2.0-85136883213
Pubmed ID
36038713
Journal Title
Intensive Care Medicine
Volume
48
Issue
11
Start Page
1539
End Page
1550
Rights Holder(s)
SCOPUS
Bibliographic Citation
Intensive Care Medicine Vol.48 No.11 (2022) , 1539-1550
Suggested Citation
Cinotti R., Mijangos J.C., Pelosi P., Haenggi M., Gurjar M., Schultz M.J., Kaye C., Godoy D.A., Alvarez P., Ioakeimidou A., Ueno Y., Badenes R., Suei Elbuzidi A.A., Piagnerelli M., Elhadi M., Reza S.T., Azab M.A., McCredie V., Stevens R.D., Digitale J.C., Fong N., Asehnoune K., Abback P.s., Codorniu A., Citerio G., Sala V.L., Astuto M., Tringali E., Alampi D., Rocco M., Maugeri J.G., Bellissima A., Filippini M., Lazzeri N., Cortegiani A., Ippolito M., Robba C., Battaglini D., Biston P., Al-Gharyani M.F., Chabanne R., Astier L., Soyer B., Gaugain S., Zimmerli A., Pietsch U., Filipovic M., Brandi G., Bicciato G., Serrano A., Monleon B., van Vliet P., Gerretsen B.M., Ortiz-Macias I.X., Oto J., Enomoto N., Matsuda T., Masui N., Garçon P., Zarka J., Vermeijden W.J., Cornet A.D., Inurrigarro S.R., Domínguez R.C.L., Bellini M.M., Haedo M.M.G., Lamot L., Orquera J., Biais M., Georges D., Baronia A., Miranda-Ackerman R.C., Barbosa-Camacho F.J., Porter J., Lopez-Morales M., Geeraerts T., Compagnon B., Pérez-Torres D., Prol-Silva E., Yahya H.B., Khaled A., Ghula M., Andrea C.N., Daniela P.M., Deana C., Vetrugno L., Chavez M.J.R., Trujillo R.M., Legros V., Brochet B., Huet O., Geslain M., van der Jagt M., van Steenkiste J., Ahmed H., Coombs A.E., Welbourne J., Pineda A.A.V., Castillo V.H.N., Azab M.A. Extubation in neurocritical care patients: the ENIO international prospective study. Intensive Care Medicine Vol.48 No.11 (2022) , 1539-1550. 1550. doi:10.1007/s00134-022-06825-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87219
Title
Extubation in neurocritical care patients: the ENIO international prospective study
Author(s)
Cinotti R.
Mijangos J.C.
Pelosi P.
Haenggi M.
Gurjar M.
Schultz M.J.
Kaye C.
Godoy D.A.
Alvarez P.
Ioakeimidou A.
Ueno Y.
Badenes R.
Suei Elbuzidi A.A.
Piagnerelli M.
Elhadi M.
Reza S.T.
Azab M.A.
McCredie V.
Stevens R.D.
Digitale J.C.
Fong N.
Asehnoune K.
Abback P.s.
Codorniu A.
Citerio G.
Sala V.L.
Astuto M.
Tringali E.
Alampi D.
Rocco M.
Maugeri J.G.
Bellissima A.
Filippini M.
Lazzeri N.
Cortegiani A.
Ippolito M.
Robba C.
Battaglini D.
Biston P.
Al-Gharyani M.F.
Chabanne R.
Astier L.
Soyer B.
Gaugain S.
Zimmerli A.
Pietsch U.
Filipovic M.
Brandi G.
Bicciato G.
Serrano A.
Monleon B.
van Vliet P.
Gerretsen B.M.
Ortiz-Macias I.X.
Oto J.
Enomoto N.
Matsuda T.
Masui N.
Garçon P.
Zarka J.
Vermeijden W.J.
Cornet A.D.
Inurrigarro S.R.
Domínguez R.C.L.
Bellini M.M.
Haedo M.M.G.
Lamot L.
Orquera J.
Biais M.
Georges D.
Baronia A.
Miranda-Ackerman R.C.
Barbosa-Camacho F.J.
Porter J.
Lopez-Morales M.
Geeraerts T.
Compagnon B.
Pérez-Torres D.
Prol-Silva E.
Yahya H.B.
Khaled A.
Ghula M.
Andrea C.N.
Daniela P.M.
Deana C.
Vetrugno L.
Chavez M.J.R.
Trujillo R.M.
Legros V.
Brochet B.
Huet O.
Geslain M.
van der Jagt M.
van Steenkiste J.
Ahmed H.
Coombs A.E.
Welbourne J.
Pineda A.A.V.
Castillo V.H.N.
Azab M.A.
Mijangos J.C.
Pelosi P.
Haenggi M.
Gurjar M.
Schultz M.J.
Kaye C.
Godoy D.A.
Alvarez P.
Ioakeimidou A.
Ueno Y.
Badenes R.
Suei Elbuzidi A.A.
Piagnerelli M.
Elhadi M.
Reza S.T.
Azab M.A.
McCredie V.
Stevens R.D.
Digitale J.C.
Fong N.
Asehnoune K.
Abback P.s.
Codorniu A.
Citerio G.
Sala V.L.
Astuto M.
Tringali E.
Alampi D.
Rocco M.
Maugeri J.G.
Bellissima A.
Filippini M.
Lazzeri N.
Cortegiani A.
Ippolito M.
Robba C.
Battaglini D.
Biston P.
Al-Gharyani M.F.
Chabanne R.
Astier L.
Soyer B.
Gaugain S.
Zimmerli A.
Pietsch U.
Filipovic M.
Brandi G.
Bicciato G.
Serrano A.
Monleon B.
van Vliet P.
Gerretsen B.M.
Ortiz-Macias I.X.
Oto J.
Enomoto N.
Matsuda T.
Masui N.
Garçon P.
Zarka J.
Vermeijden W.J.
Cornet A.D.
Inurrigarro S.R.
Domínguez R.C.L.
Bellini M.M.
Haedo M.M.G.
Lamot L.
Orquera J.
Biais M.
Georges D.
Baronia A.
Miranda-Ackerman R.C.
Barbosa-Camacho F.J.
Porter J.
Lopez-Morales M.
Geeraerts T.
Compagnon B.
Pérez-Torres D.
Prol-Silva E.
Yahya H.B.
Khaled A.
Ghula M.
Andrea C.N.
Daniela P.M.
Deana C.
Vetrugno L.
Chavez M.J.R.
Trujillo R.M.
Legros V.
Brochet B.
Huet O.
Geslain M.
van der Jagt M.
van Steenkiste J.
Ahmed H.
Coombs A.E.
Welbourne J.
Pineda A.A.V.
Castillo V.H.N.
Azab M.A.
Author's Affiliation
IRCCS San Martino Polyclinic Hospital
Sanatorio Pasteur, Argentina
Tokushima University Hospital
Hamad Medical Corporation
University of Al-Fateh Faculty of Medicine
Hospital Maciel Montevideo
Hospital Civil de Guadalajara
Nantes Université
CHU de Nantes
Università degli Studi di Genova
Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow
Aberdeen Royal Infirmary
University of California, San Francisco
Dhaka Medical College and Hospital
Hospital Clinico Universitario de Valencia
Mahidol University
University Hospital Bern
Cairo University
Universidad de Guadalajara
Nuffield Department of Medicine
Toronto Western Hospital University of Toronto
Amsterdam UMC - University of Amsterdam
Johns Hopkins School of Medicine
Université Libre de Bruxelles
Sanatorio Pasteur, Argentina
Tokushima University Hospital
Hamad Medical Corporation
University of Al-Fateh Faculty of Medicine
Hospital Maciel Montevideo
Hospital Civil de Guadalajara
Nantes Université
CHU de Nantes
Università degli Studi di Genova
Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow
Aberdeen Royal Infirmary
University of California, San Francisco
Dhaka Medical College and Hospital
Hospital Clinico Universitario de Valencia
Mahidol University
University Hospital Bern
Cairo University
Universidad de Guadalajara
Nuffield Department of Medicine
Toronto Western Hospital University of Toronto
Amsterdam UMC - University of Amsterdam
Johns Hopkins School of Medicine
Université Libre de Bruxelles
Other Contributor(s)
Abstract
Purpose: Neurocritical care patients receive prolonged invasive mechanical ventilation (IMV), but there is poor specific information in this high-risk population about the liberation strategies of invasive mechanical ventilation. Methods: ENIO (NCT03400904) is an international, prospective observational study, in 73 intensive care units (ICUs) in 18 countries from 2018 to 2020. Neurocritical care patients with a Glasgow Coma Score (GCS) ≤ 12, receiving IMV ≥ 24 h, undergoing extubation attempt or tracheostomy were included. The primary endpoint was extubation failure by day 5. An extubation success prediction score was created, with 2/3 of patients randomly allocated to the training cohort and 1/3 to the validation cohort. Secondary endpoints were the duration of IMV and in-ICU mortality. Results: 1512 patients were included. Among the 1193 (78.9%) patients who underwent an extubation attempt, 231 (19.4%) failures were recorded. The score for successful extubation prediction retained 20 variables as independent predictors. The area under the curve (AUC) in the training cohort was 0.79 95% confidence interval (CI95) [0.71–0.87] and 0.71 CI95 [0.61–0.81] in the validation cohort. Patients with extubation failure displayed a longer IMV duration (14 [7–21] vs 6 [3–11] days) and a higher in-ICU mortality rate (8.7% vs 2.4%). Three hundred and nineteen (21.1%) patients underwent tracheostomy without extubation attempt. Patients with direct tracheostomy displayed a longer duration of IMV and higher in-ICU mortality than patients with an extubation attempt (success and failure). Conclusions: In neurocritical care patients, extubation failure is high and is associated with unfavourable outcomes. A score could predict extubation success in multiple settings. However, it will be mandatory to validate our findings in another prospective independent cohort.
