Extubation in the pediatric intensive care unit: predictive methods. An integrative literature review

Area of Science:

• Pediatric critical care medicine
• Respiratory physiology

Background:

• Evaluating extubation readiness in pediatric patients is essential.
• Current methods lack a definitively superior tool over clinical judgment.
• Predicting extubation failure is critical for patient outcomes.

Purpose of the Study:

• To review common clinical techniques used to predict extubation failure in pediatric patients.
• To analyze the performance of frequently utilized predictive variables.

Main Methods:

• Systematic literature search of PubMed, BVS, Cochrane Library, and Scopus.
• Survey and analysis of commonly used predictive variables for extubation failure.
• Descriptive analysis of eight identified predictors.

Main Results:

• Three predictors were most commonly used: spontaneous breathing test, rapid shallow breathing index, and maximum inspiratory pressure.
• Data disparity prevented statistical analysis, but test performance was described.
• Identified and analyzed eight predictors of extubation failure.

Conclusions:

• Spontaneous breathing test, rapid shallow breathing index, and maximum inspiratory pressure are frequently employed in clinical practice.
• Further research is needed to establish a superior method for predicting extubation failure.
• Understanding the performance of these tests aids clinical decision-making.