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Endotracheal Tube Extubation

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.

Tracheostomy: Procedure and Tubes

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...

Tracheostomy Decannulation

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...

Endotracheal Intubation I: Procedure

Endotracheal Intubation I: Procedure

Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...

Trachea

Trachea

The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...

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Related Experiment Video

Updated: May 14, 2026

A Structured Approach to Extubation in Mechanically Ventilated Rats

A Structured Approach to Extubation in Mechanically Ventilated Rats

Published on: July 18, 2025

Early tracheal stenosis causing extubation failure and prolonged ventilator dependency.

L Dalar¹, M M Schuurmans, E Eryuksel

¹Yedikule Teaching and Research Hospital, Istanbul, Turkey. leventdalar@gmail.com

Anaesthesia and Intensive Care

|February 1, 2013

Summary

Postintubation tracheal stenosis, a common complication, can lead to reintubation and delayed intensive care unit weaning. Early recognition and rigid bronchoscopy intervention are crucial for managing this condition.

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Area of Science:

Pulmonology
Critical Care Medicine

Background:

Postintubation tracheal stenosis is a frequent cause of benign tracheal stenosis.
It can lead to reintubation and delayed weaning in intensive care unit (ICU) patients.

Observation:

This case study details five patients with early intubation-related tracheal stenosis requiring reintubation and mechanical ventilation.
Symptoms included stridor post-extubation, diagnosed via bronchoscopy.
Two patients presented already on ventilators.

Findings:

Rigid bronchoscopy with dilatation and silicone stent placement was performed in all cases.
Successful intervention resolved hypercapnia and hypoxia in three patients.
Outcomes for the remaining two included tracheostomy closure and ventilation cessation with tracheostomy maintenance.

Implications:

Tracheal stenosis, particularly in the subglottic region post-extubation, necessitates consideration in weaning/extubation failure.
Prompt diagnosis and treatment via rigid bronchoscopy can improve patient outcomes.
Tracheostomy may mask progressive stenosis, potentially prolonging ventilation unnecessarily.