Related Experiment Video
Updated: May 28, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Predictors of extubation success in patients with middle cerebral artery acute ischemic stroke
Linda C Wendell1, Jonathan Raser, Scott Kasner
1Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Abstract:
Introduction. Stroke patients often meet respiratory guidelines for extubation, but uncertainty exists if patients will protect their airway due to impaired mental status. Patients with middle cerebral artery (MCA) acute ischemic stroke (AIS) might have specific predictors of successful extubation. Methods. Retrospective cohort of MCA AIS patients requiring intubation. Results. Thirty-seven MCA AIS patients were extubated successfully and ten failed extubation. Those who successfully extubated had higher extubation composite and eye response Glasgow Coma Scale (GCS) scores compared to those who failed (median 10T (IQR 9T-11T) versus 9.5T (8T-10T), P = 0.047, and 4 (3-4) versus 2.5 (1-3), P < 0.01). When adjusted for age, admission National Institutes of Health Stroke Scale score and laterality, patients with a GCS score ≥8T trended toward extubating successfully (OR 23.30 (CI 0.94-580.27), P = 0.055). Conclusions. The GCS score might be important in predicting successful extubation in MCA AIS patients. Further prospective study is warranted to better assess factors predictive of extubation outcome in stroke and other brain-injured patients.
Insights
The Glasgow Coma Scale (GCS) score may predict successful extubation in acute ischemic stroke patients with middle cerebral artery blockages. Higher GCS scores indicate a better chance of successful extubation after intubation.
Area of Science:
- Neurology
- Critical Care Medicine
Background:
- Stroke patients often meet extubation criteria but airway protection remains a concern due to impaired mental status.
- Identifying predictors for successful extubation in middle cerebral artery (MCA) acute ischemic stroke (AIS) patients is crucial.
Purpose of the Study:
- To investigate predictors of successful extubation in patients with MCA AIS.
- To evaluate the role of the Glasgow Coma Scale (GCS) in predicting extubation outcomes.
Main Methods:
- Retrospective cohort study of MCA AIS patients requiring mechanical ventilation.
- Analysis of extubation success rates and correlation with GCS scores and other clinical factors.
Main Results:
- Thirty-seven out of 47 MCA AIS patients were successfully extubated.
- Successful extubation was associated with higher extubation composite and eye response GCS scores.
- A GCS score of 8 or higher trended towards successful extubation, even after adjusting for other variables.
Conclusions:
- The GCS score appears to be an important predictor of successful extubation in MCA AIS patients.
- Further prospective research is needed to confirm these findings and explore other predictive factors for extubation success in brain-injured patients.
