Renal Function Markers Predicts Extubation Failure in Critically Ill Patients: A Retrospective Study.

Area of Science:

• Nephrology
• Critical Care Medicine
• Pulmonology

Background:

• Predicting extubation success from mechanical ventilation remains challenging.
• Existing predictors for extubation and weaning lack consistent accuracy.
• The role of renal function in extubation outcomes requires further investigation.

Purpose of the Study:

• To evaluate the association between renal function markers and extubation failure.
• To determine if acute kidney injury (AKI) predicts the need for reintubation.
• To identify specific renal parameters relevant to extubation decisions.

Main Methods:

• Retrospective study analyzing electronic medical records over two years.
• Inclusion criteria: adult patients (≥18 years) on invasive mechanical ventilation (MV) for ≥48 hours.
• Extubation failure defined as reintubation within 48 hours of tracheal tube removal; AKI assessed by KDIGO classification.

Main Results:

• 15% of 167 subjects experienced extubation failure.
• Extubation failure group showed lower creatinine clearance (42 mL/min vs 100 mL/min) and higher fluid balance (739 mL vs -189 mL).
• Patients with AKI had a 2.7-fold increased likelihood of extubation failure (OR=2.7; 95% CI: 1.6-4.7; P<0.01).

Conclusions:

• Renal dysfunction is significantly associated with higher rates of extubation failure.
• Fluid balance and serum creatinine levels are potential factors to consider during extubation decisions.
• Assessing renal function may improve the prediction of successful extubation and reduce reintubation rates.