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Peñuelas, F. Frutos-Vivar, F. Gordo, C. Apezteguía, M.I. Restrepo, M. González, Y. Arabi, C. Santos, J.A. Alhashemi, F. Pérez, A. Esteban, A. Anzueto" "autores" => array:12 [ 0 => array:2 [ "nombre" => "O." "apellidos" => "Peñuelas" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Frutos-Vivar" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Gordo" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Apezteguía" ] 4 => array:2 [ "nombre" => "M.I." "apellidos" => "Restrepo" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "González" ] 6 => array:2 [ "nombre" => "Y." "apellidos" => "Arabi" ] 7 => array:2 [ "nombre" => "C." "apellidos" => "Santos" ] 8 => array:2 [ "nombre" => "J.A." "apellidos" => "Alhashemi" ] 9 => array:2 [ "nombre" => "F." "apellidos" => "Pérez" ] 10 => array:2 [ "nombre" => "A." "apellidos" => "Esteban" ] 11 => array:2 [ "nombre" => "A." "apellidos" => "Anzueto" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173572713000210" "doi" => "10.1016/j.medine.2012.03.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572713000210?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569112001416?idApp=WMIE" "url" => "/02105691/0000003700000003/v2_201304221214/S0210569112001416/v2_201304221214/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2173572713000222" "issn" => "21735727" "doi" => "10.1016/j.medine.2012.03.007" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "454" "copyright" => "Elsevier España, S.L. and SEMICYUC" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Intensiva. 2013;37:149-55" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5071 "formatos" => array:3 [ "EPUB" => 144 "HTML" => 3945 "PDF" => 982 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Prognosis of elderly patients subjected to mechanical ventilation in the ICU" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "149" "paginaFinal" => "155" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pronóstico de los ancianos ventilados mecánicamente en la UCI" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1875 "Ancho" => 2181 "Tamanyo" => 297534 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Spanish population pyramid 2009–2049, according to the simulation made by the National Institute of Statistics (INE).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. 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"apellidos" => "Choperena" ] 12 => array:2 [ "nombre" => "R." "apellidos" => "Díaz-Alersi" ] 13 => array:2 [ "nombre" => "J.C." "apellidos" => "Montejo" ] 14 => array:2 [ "nombre" => "J." "apellidos" => "López-Martínez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572713000222?idApp=WMIE" "url" => "/21735727/0000003700000003/v1_201306141526/S2173572713000222/v1_201306141526/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Outcome of tracheotomized patients following reintubation" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "148" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "O. Peñuelas, F. Frutos-Vivar, F. Gordo, C. Apezteguía, M.I. Restrepo, M. González, Y. Arabi, C. Santos, J.A. Alhashemi, F. Pérez, A. Esteban, A. Anzueto" "autores" => array:12 [ 0 => array:4 [ "nombre" => "O." "apellidos" => "Peñuelas" "email" => array:1 [ 0 => "openuelas@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Frutos-Vivar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "F." "apellidos" => "Gordo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "C." "apellidos" => "Apezteguía" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "M.I." 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Posadas, Buenos Aires, Argentina" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "VERDICT at South Texas Veterans Health Care System, Audie L. Murphy Division and University of Texas Health Science Center, San Antonio, TX, USA" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Clinica Medellín & Universidad Pontificia Bolivariana, Medellín, Colombia" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Hospital de Clínicas de Montevideo, Montevideo, Uruguay" "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "King Abdulaziz University, Jeddah, Saudi Arabia" "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Hospital de Clínicas de Caracas, Caracas, Venezuela" "etiqueta" => "<span class="elsevierStyleSup">i</span>" "identificador" => "aff0045" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Desenlace de los enfermos traqueotomizados después de la reintubación" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1671 "Ancho" => 2141 "Tamanyo" => 169179 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the patients analyzed in the study.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tracheotomy is a common practice in patients admitted to the Intensive Care Unit (ICU) and subjected to mechanical ventilation.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> The technique offers a number of potential advantages over prolonged translaryngeal intubation in terms of patient comfort, a lesser need for sedation, and improved weaning from the ventilator.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> One-third of all the tracheotomies are performed in situations where programmed extubation has failed and reintubation is required.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However, little information is available on the possible benefits of tracheotomy in the initial days after reintubation. The present study analyzes the outcome of patients with tracheotomy after failure of extubation as compared with patients in whom tracheotomy was not performed.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">A secondary analysis was performed of an international, multicenter prospective study carried out in 36 ICUs in 8 countries (see <a class="elsevierStyleCrossRef" href="#sec0050">Appendix A</a>) between September 2005 and December 2006.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Given the observational and non-interventional nature of its design, the corresponding Ethics Committee approved the study without the need for informed consent.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients</span><p id="par0015" class="elsevierStylePara elsevierViewall">We included adult patients requiring mechanical ventilation for more than 48<span class="elsevierStyleHsp" style=""></span>h and with programmed extubation after a successful spontaneous breathing test. Patients with previous tracheotomy were excluded.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Follow-up</span><p id="par0020" class="elsevierStylePara elsevierViewall">The included patients were evaluated daily to identify the criteria for conducting a spontaneous breathing test: (a) resolution or improvement of the condition leading to the need for mechanical ventilation; (b) patient alertness and capacity to communicate; (c) core temperature <38<span class="elsevierStyleHsp" style=""></span>°C; (d) absence of vasoactive medication (with exclusion of dopamine <5<span class="elsevierStyleHsp" style=""></span>μg/kg/min); and (e) a PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratio of >200 with positive end-expiratory pressure (PEEP) no greater than 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O. When the patients met these criteria, a spontaneous breathing test was performed with a T-tube or continuous positive airway pressure (CPAP), or supportive pressure ≤7<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O. After 5<span class="elsevierStyleHsp" style=""></span>min and at the end of the spontaneous breathing test, we recorded the following variables: arterial blood gas values, tidal volume measured with a spirometer or from the ventilator, respiratory frequency, heart rate, systolic blood pressure, and the Richmond agitation-sedation scale (RASS). The physician in charge determined whether the patient presented any of the following signs of poor tolerance: a respiratory frequency of >35<span class="elsevierStyleHsp" style=""></span>rpm, SatO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>90%, a heart rate of >140<span class="elsevierStyleHsp" style=""></span>bpm, or an increase or decrease in heart rate of over 20% with respect to the basal rate, systolic blood pressure >200<span class="elsevierStyleHsp" style=""></span>mmHg or <80<span class="elsevierStyleHsp" style=""></span>mmHg, and agitation, perspiration or anxiety. The patients who failed to tolerate the spontaneous breathing test received mechanical ventilation. In these patients, a daily spontaneous breathing test was made until the time of extubation. To the effects of the study, the analysis included the data corresponding to the spontaneous breathing tests that were followed by extubation.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patients who tolerated the spontaneous breathing test were extubated in the subsequent 120<span class="elsevierStyleHsp" style=""></span>min after the start of the test and were subjected to follow-up during the next 48<span class="elsevierStyleHsp" style=""></span>h or until discharge from the ICU – whichever occurred first. The decision to remove the tube was taken by the physician in charge of the patient. Given the observational and non-interventional nature of the study, the criteria for indicating reintubation were not protocolized.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the case of reintubation, we recorded the date and time, as well as the reason for reintubation, previously classified as: upper airway obstruction (defined as stridor and/or laryngeal edema), increased respiratory effort (defined as a respiratory frequency >35<span class="elsevierStyleHsp" style=""></span>rpm and/or use of the accessory muscles), diminished consciousness (defined as a score of under 0 on the Richmond agitation-sedation scale), hypoxemia (defined as SatO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>90% despite FiO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.5), or respiratory acidosis (defined as arterial pH<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>7.30 with PaCO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mmHg). The reintubated patients were followed-up on during the new period of mechanical ventilation for a maximum of 15 days. During this time, a daily registry was made of the appearance of new complications after reintubation such as acute respiratory distress syndrome, sepsis, ventilator-associated pneumonia (VAP), or organ failure (cardiovascular, renal, hepatic, hematological), defined as a score of over two points on the Sepsis-related Organ Failure Assessment (SOFA) scale.</p><p id="par0035" class="elsevierStylePara elsevierViewall">During the follow-up period, the performance and date of tracheotomy were recorded (the indications of tracheotomy were not protocolized), or the date of the second extubation was registered. The reintubated patients were classified into two groups according to the performance or not of tracheotomy: tracheotomy group (patients subjected to tracheotomy after first reintubation) and non-tracheotomy group. The patient condition at discharge from the ICU was documented in all cases.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">The data are expressed as percentage, mean (standard deviation) and median (interquartile range), as applicable. Continuous variables were compared using the Student <span class="elsevierStyleItalic">t</span>-test or Mann–Whitney <span class="elsevierStyleItalic">U</span>-test, while categorical variables were compared using the chi-squared test or the Fisher exact test. Multiple linear regression analysis was performed to identify the independent variables associated to the duration of stay in the ICU. The following variables were included in the model: age, SAPS II score, initial reason for mechanical ventilation, days of mechanical ventilation prior to first extubation, tracheotomy and post-reintubation complications. Statistical significance was considered for <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05. The SPSS version 17.0 statistical package (SPSS Inc., Chicago, IL, USA) was used throughout.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">From a cohort of 1152 patients subjected to programmed extubation, we analyzed 180 reintubated patients (16%), divided into two groups: 52 patients (29%) tracheotomized after reintubation and 128 patients in principle not subjected to tracheotomy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The median time from reintubation to tracheotomy was 2.5 days (interquartile range 1.8). <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> compares the basal characteristics of the two groups. In the tracheotomy group there were more patients requiring mechanical ventilation due to neurological disease (23% vs 11%, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04), while the non-tracheotomy group was characterized by more patients with pneumonia (19% vs 6%, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.03). The patients with tracheotomy had a higher incidence of sepsis and ventilator associated pneumonia after reintubation (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The tracheotomy group had a significantly longer stay than the non-tracheotomized patients (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). In the multiple linear regression analysis, three variables were associated with a longer stay in the ICU: days of mechanical ventilation prior to extubation (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001), post-reintubation sepsis (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001) and tracheotomy (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.025).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The mortality rate in the ICU proved similar in both groups: 31% in the tracheotomy group versus 27% in the non-tracheotomy group (relative risk of tracheotomy: 1.16; 95% confidence interval: 0.70–1.90; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.57).</p><p id="par0060" class="elsevierStylePara elsevierViewall">The mortality rate was similar in the patients with early tracheotomy (in the first 3 days after reintubation) and in those in which tracheotomy was performed after the third post-extubation day: 32% versus 29% (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.82).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">The main finding of this observational study is that tracheotomy in patients who have required reintubation does not offer advantages in terms of the duration of stay in the ICU or mortality as compared with patients in which tracheotomy is not performed after the first reintubation.</p><p id="par0070" class="elsevierStylePara elsevierViewall">In recent years there has been a significant increase in the number of tracheotomies performed in patients subjected to mechanical ventilation,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> this being partially conditioned by introduction of the percutaneous technique in routine clinical practice.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a> Tracheotomy, in comparison to prolonged translaryngeal intubation, has demonstrated advantages in terms of patient comfort, a lesser need for sedation, oral intake, improved oral hygiene, or a faster recovery of speech.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> There is greater controversy regarding its possible advantages related to other clinical outcomes such as the incidence of ventilator associated pneumonia,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> faster weaning from mechanical ventilation,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> patient safety<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13</span></a> or, most importantly, mortality and the duration of stay in the ICU.</p><p id="par0075" class="elsevierStylePara elsevierViewall">A recent metaanalysis<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> including 7 randomized clinical trials comparing early tracheotomy versus late tracheotomy or prolonged intubation has found that early tracheotomy does not reduce mortality during the first 90 days of stay (relative risk: 0.86; 95% confidence interval: 0.65–1.13). Early tracheotomy likewise is not associated with a shortening of stay in the ICU (weighted mean difference: −6.93 days; 95% confidence interval: −16.50 to 2.63).</p><p id="par0080" class="elsevierStylePara elsevierViewall">In addition to either early or late, tracheotomy can be classified in relation to the course of mechanical ventilation: during ventilatory support, during weaning from mechanical ventilation or after the failure of extubation and the start of a new episode of mechanical ventilation. In a previous analysis by our group, we found that in one-third of the patients tracheotomy was performed after the failure of extubation.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> To date, no study had evaluated the effect of tracheotomy in the subgroup of patients who are tracheotomized after reintubation due to post-extubation respiratory failure.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Our study has shown that independently of other variables, patients with tracheotomy after reintubation had a longer stay. In contrast to other observational studies<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,15–18</span></a> in which tracheotomized patients were reported to have lesser mortality in the ICU, in our patient cohort the mortality rate was similar in both groups–this observation probably being related to differences in the populations included in the studies.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Our study has a number of limitations. Firstly, the limited sample size may have accounted for some of the observations, and precluded the use of more sophisticated statistical analyses such as for example a trend index to determine the individual probability of tracheotomy, which would have allowed a better estimation of the effect of tracheotomy upon the primary outcome variable. Secondly, the observational, non-interventional nature of the study implies that neither the decision to reintubate nor the decision to perform tracheotomy was protocolized, and was left to the criterion of the physician in charge of the patient. In this context, there may have been selection bias, since on one hand tracheotomy was more frequent in patients in which coma constituted the indication of ventilation–this population presenting a poorer prognosis<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>–while on the other hand tracheotomy is usually decided in patients considered to have a more favorable vital prognosis. In our study there were no differences in severity upon admission to the ICU, though no severity index was recorded at the time of reintubation or at the time of tracheotomy.</p><p id="par0095" class="elsevierStylePara elsevierViewall">In conclusion, we have not found tracheotomy after failed extubation to offer advantages over the maintenance of translaryngeal intubation. In any case, these findings must be considered to serve the purpose of generating hypotheses, and the true effect of tracheotomy after reintubation must be evaluated in the context of a randomized, prospective and controlled clinical trial.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Financial support</span><p id="par0100" class="elsevierStylePara elsevierViewall">This study has been funded by the <span class="elsevierStyleGrantSponsor">CIBER de Enfermedades Respiratorias, Instituto Carlos III, Spain</span>.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres189723" "titulo" => array:8 [ 0 => "Abstract" 1 => "Objective" 2 => "Method" 3 => "Patients" 4 => "Interventions" 5 => "Outcomes" 6 => "Results" 7 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec177063" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres189724" "titulo" => array:9 [ 0 => "Resumen" 1 => "Objetivo" 2 => "Diseño" 3 => "Ámbito" 4 => "Pacientes" 5 => "Intervenciones" 6 => "Variables de interés principal" 7 => "Resultados" 8 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec177064" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Follow-up" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Financial support" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-01-09" "fechaAceptado" => "2012-03-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec177063" "palabras" => array:4 [ 0 => "Reintubation" 1 => "Tracheotomy" 2 => "Mechanical ventilation" 3 => "Mortality" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec177064" "palabras" => array:4 [ 0 => "Reintubación" 1 => "Traqueotomía" 2 => "Ventilación mecánica" 3 => "Mortalidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the outcome of tracheotomized patients after reintubation.</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Secondary analysis from a prospective, multicenter and observational study including 36 Intensive Care Units (ICUs) from 8 countries was carried out.</p> <span class="elsevierStyleSectionTitle">Patients</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 180 patients under mechanical ventilation for more than 48<span class="elsevierStyleHsp" style=""></span>h, were extubated and reintubated within 48<span class="elsevierStyleHsp" style=""></span>h.</p> <span class="elsevierStyleSectionTitle">Interventions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">None.</p> <span class="elsevierStyleSectionTitle">Outcomes</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">ICU mortality, length of ICU stay, organ failure.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Fifty-two patients (29%) underwent tracheotomy after reintubation. The median time from reintubation to tracheotomy was 2.5 days (interquartile range (IQR) 1–8 days). The length of ICU stay was significantly longer in the tracheotomy group as compared with the group without tracheotomy (median time 25 days, IQR 17–43 versus 16.5 days (IQR 11–25); <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). ICU mortality in the tracheotomy group was not significantly different (31% vs 27%; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.57).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In our cohort of reintubated patients, tracheotomy is a common procedure in the ICU. Patients with tracheotomy had an outcome similar to those without tracheotomy.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Evaluar el desenlace de pacientes que fueron traqueotomizados tras una reintubación.</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Análisis secundario de un estudio de cohorte prospectivo.</p> <span class="elsevierStyleSectionTitle">Ámbito</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Treinta y seis unidades de cuidados intensivos de 8 países.</p> <span class="elsevierStyleSectionTitle">Pacientes</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">180 pacientes con ventilación mecánica durante más de 48 horas extubados y que requirieron reintubación en las primeras 48 horas.</p> <span class="elsevierStyleSectionTitle">Intervenciones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Ninguna.</p> <span class="elsevierStyleSectionTitle">Variables de interés principal</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Mortalidad en la Unidad de Cuidados Intensivos, días de estancia en la unidad de cuidados intensivos, fracaso de órganos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Cincuenta y dos pacientes (29%) fueron traqueotomizados inicialmente después de reintubación. La mediana de tiempo desde la reintubación a la traqueotomía fue de 2,5 días (rango inter-cuartil: 1, 8). La duración de la estancia en la UCI fue significativamente mayor en el grupo de traqueotomía, en comparación con el grupo inicialmente sin traqueotomía [mediana de 25 días (rango inter-cuartil: 17, 43) versus 16,5 días (rango inter-cuartil: 11, 25); p <0,001]. En el grupo de traqueotomía no se observó una menor mortalidad (31% frente al 27%; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,57).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">En nuestra cohorte, la traqueotomía después de reintubación es un procedimiento común pero no ofrece ninguna ventaja significativa.</p>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Peñuelas O, et al. Desenlace de los enfermos traqueotomizados después de la reintubación. Med Intensiva. 2012. <span class="elsevierStyleInterRef" href="doi:10.1016/j.medin.2012.03.013">http://dx.doi.org/10.1016/j.medin.2012.03.013</span>.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara">Study presented by Óscar Peñuelas in June 2010 as an oral communication at the XLV National Congress of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC).</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:3 [ "apendice" => "<p id="par0110" class="elsevierStylePara elsevierViewall">The collaborating investigators who participated in this study were:</p> <p id="par0115" class="elsevierStylePara elsevierViewall">Argentina: <span class="elsevierStyleItalic">Coordinator:</span> Carlos Apezteguia (Hospital Profesor A. Posadas, El Palomar, Buenos Aires). Investigators: Fernando Villarejo, Enrique Pezzola, Juan Hidalgo (Hospital Profesor A. Posadas, Buenos Aires); Margarita Tavella, Roberto Villa (Hospital de Clínicas José de San Martín, Buenos Aires); Luis Pablo Cardonet, Ana Rosa Diez, Verónica Fernandes (Hospital Provincial del Centenario, Rosario); Christian Casabella, Fernando Palizas Jr (Clínica Bazterrica, Buenos Aires); Gonzalo Ferrara, America Toro (HIGA San Martín de la Plata, Buenos Aires); Enrique Pablo Centeno, Martin Eduardo Arzel (Hospital de González Catán); Ariel Chena, Graciela Zakaik (Hospital Luis Lagomaggiore, Mendoza); Martin Deheza, Marina Papucci (Hospital General de Agudos Bernardino Rivadavia, Buenos Aires); Pablo Pratesi, Javier Álvarez (Hospital Universitario Austral, Derqui); Miriam Moseinco, Marcelo Engel (Sanatorio Otamendi y Miroli, Buenos Aires); Alejandra Balbiani, Orlando Hamada (Hospital San Juan de Dios, Ramos Mejia); Patricia Spinelli, Imelda Perdomo (Sanatorio Trinidad San Isidro); Sergio Lasdica, Rogelio Urizar (Hospital Municipal de Coronel Suárez Dr. Raúl Caccavo).</p> <p id="par0120" class="elsevierStylePara elsevierViewall">Bolivia: Fredi Sandi Lora, Fernando Renjel Jáuregui (Hospital Obrero número 1, La Paz).</p> <p id="par0125" class="elsevierStylePara elsevierViewall">Colombia: <span class="elsevierStyleItalic">Coordinator:</span> Marco A. González (Clínica Medellín y Universidad Pontificia Bolivariana, Medellín). Investigators: Marcela Granados (Fundación del Valle del Lilly, Cali), Rubén Camargo (Hospital General del Norte), Carmelo Dueñas (Hospital Bocagrande, Cartagena), Guillermo Ortiz (Hospital Santa Clara, Bogota), Francisco Molina (Clínica Universitaria Bolivariana, Medellín).</p> <p id="par0130" class="elsevierStylePara elsevierViewall">Saudi Arabia: Yaseen Arabi (King Fahad National Guard Hospital, Riyadh), Jamal A. Alhashemi (King Abdulaziz University, Jeddah).</p> <p id="par0135" class="elsevierStylePara elsevierViewall">Spain: <span class="elsevierStyleItalic">Coordinator</span>: Federico Gordo (Hospital del Henares, Coslada).</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Eva Manteiga, Oscar Martínez, Oscar Peñuelas (Hospital Universitario de Getafe); Jordi Ibáñez (Hospital Son Dureta, Palma de Mallorca); Marta López (Hospital Marqués de Valdecilla, Santander); Enrique Calvo Herranz (Fundación Hospital Alcorcón); Luís Eugenio Palazón (Hospital General Universitario Reina Sofía, Murcia); Enrique Fernández Mondéjar (Hospital Virgen de las Nieves, Granada), Rafael Fernández (Hospital de Sabadell); Noelia Lázaro, Santiago Macias (Hospital General de Segovia); Ángela Alonso (Hospital de Fuenlabrada); Raúl de Pablo (Hospital Príncipe de Asturias, Alcalá de Henares), Guillermo Muñiz Albaiceta (Hospital Central de Asturias, Oviedo); Margarita Mas (Hospital de Móstoles); Gemma Rialp (Hospital Son LLàtzer, Palma de Mallorca), Arantxa Mas (Fundación Altahaia, Manresa).</p> <p id="par0145" class="elsevierStylePara elsevierViewall">United States: Marcos I. Restrepo, Antonio Anzueto (South Texas Veterans Health Care System Audie L. Murphy Division and University of Texas Health Science Center, San Antonio, Texas).</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Uruguay: Cristina Santos (Hospital de Clínicas de Montevideo).</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Venezuela: Fernando Pérez (Hospital de Clínicas de Caracas).</p>" "etiqueta" => "Appendix A" "identificador" => "sec0050" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1671 "Ancho" => 2141 "Tamanyo" => 169179 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the patients analyzed in the study.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">SD: standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Tracheotomy (No.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No tracheotomy (No.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>128) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Basal characteristics</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Age, mean (SD), years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 (18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Females, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 (42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.42 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SAPS II upon admission, mean (SD), points \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Cause of start of mechanical ventilation, n (%)</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Chronic obstructive pulmonary disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Acute respiratory failure</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Postoperative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.71 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pneumonia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sepsis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.91 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Trauma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Congestive heart failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiac arrest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.63 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acute respiratory distress syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Aspiration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurological disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neuromuscular disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation prior to extubation, median (interquartile range), days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (5, 12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (4, 10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Richmond agitation-sedation score at the time of extubation, n (%)</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>−5 to −1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (69) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>+1 to +4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.71 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Richmond agitation-sedation score before reintubation, n (%)</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>−5 to −1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>+1 to +4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Time to reintubation, median (interquartile range), h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (6, 23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (6, 24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.72 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Reason for reintubation</span>, n <span class="elsevierStyleItalic">(%)</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Upper airway obstruction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.72 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Increased respiratory effort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (44.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (61.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diminished consciousness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypoxemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratory acidosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.68 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Complications after reintubation</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acute respiratory distress syndrome, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (13.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventilator associated pneumonia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sepsis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Organ failure</span>, n <span class="elsevierStyleItalic">(%)</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiovascular failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (13.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.63 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Liver failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hematological failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (11.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab288329.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Comparison of the basal characteristics and complications after reintubation in both groups.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Tracheotomy (No.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No tracheotomy (No.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>128) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Days from reintubation to discharge from the ICU, median (interquartile range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (7, 29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (4, 15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Survived \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (5, 31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (5.14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Deceased \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (12, 29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (2, 19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Days of stay in the ICU, median (interquartile range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (17, 43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.5 (11, 25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Survived \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (14, 48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (11, 24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Deceased \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (42, 23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (11, 31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality in the ICU, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.57 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab288328.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Comparison of the main outcome variables.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of tracheostomy in ICU patients: a nation-wide survey in Switzerland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. 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Year/Month | Html | Total | |
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2024 November | 10 | 14 | 24 |
2024 October | 65 | 56 | 121 |
2024 September | 74 | 34 | 108 |
2024 August | 97 | 56 | 153 |
2024 July | 69 | 43 | 112 |
2024 June | 59 | 53 | 112 |
2024 May | 61 | 44 | 105 |
2024 April | 48 | 37 | 85 |
2024 March | 54 | 28 | 82 |
2024 February | 70 | 47 | 117 |
2024 January | 46 | 50 | 96 |
2023 December | 54 | 48 | 102 |
2023 November | 48 | 26 | 74 |
2023 October | 57 | 44 | 101 |
2023 September | 50 | 48 | 98 |
2023 August | 48 | 43 | 91 |
2023 July | 46 | 39 | 85 |
2023 June | 27 | 32 | 59 |
2023 May | 43 | 30 | 73 |
2023 April | 42 | 20 | 62 |
2023 March | 88 | 40 | 128 |
2023 February | 84 | 41 | 125 |
2023 January | 79 | 47 | 126 |
2022 December | 111 | 50 | 161 |
2022 November | 111 | 42 | 153 |
2022 October | 70 | 33 | 103 |
2022 September | 73 | 48 | 121 |
2022 August | 56 | 82 | 138 |
2022 July | 49 | 74 | 123 |
2022 June | 46 | 40 | 86 |
2022 May | 54 | 54 | 108 |
2022 April | 43 | 58 | 101 |
2022 March | 63 | 71 | 134 |
2022 February | 58 | 45 | 103 |
2022 January | 102 | 53 | 155 |
2021 December | 74 | 56 | 130 |
2021 November | 72 | 55 | 127 |
2021 October | 128 | 69 | 197 |
2021 September | 106 | 52 | 158 |
2021 August | 83 | 45 | 128 |
2021 July | 61 | 40 | 101 |
2021 June | 53 | 48 | 101 |
2021 May | 101 | 50 | 151 |
2021 April | 164 | 81 | 245 |
2021 March | 137 | 28 | 165 |
2021 February | 87 | 36 | 123 |
2021 January | 86 | 25 | 111 |
2020 December | 68 | 27 | 95 |
2020 November | 51 | 31 | 82 |
2020 October | 88 | 36 | 124 |
2020 September | 71 | 28 | 99 |
2020 August | 78 | 22 | 100 |
2020 July | 57 | 29 | 86 |
2020 June | 82 | 24 | 106 |
2020 May | 71 | 18 | 89 |
2020 April | 65 | 22 | 87 |
2020 March | 43 | 21 | 64 |
2020 February | 144 | 28 | 172 |
2020 January | 68 | 33 | 101 |
2019 December | 61 | 48 | 109 |
2019 November | 38 | 21 | 59 |
2019 October | 53 | 26 | 79 |
2019 September | 54 | 31 | 85 |
2019 August | 48 | 29 | 77 |
2019 July | 50 | 34 | 84 |
2019 June | 47 | 34 | 81 |
2019 May | 64 | 77 | 141 |
2019 April | 54 | 25 | 79 |
2019 March | 49 | 26 | 75 |
2019 February | 47 | 27 | 74 |
2019 January | 41 | 30 | 71 |
2018 December | 64 | 76 | 140 |
2018 November | 150 | 68 | 218 |
2018 October | 179 | 31 | 210 |
2018 September | 69 | 11 | 80 |
2018 August | 66 | 7 | 73 |
2018 July | 42 | 11 | 53 |
2018 June | 56 | 14 | 70 |
2018 May | 45 | 4 | 49 |
2018 April | 40 | 8 | 48 |
2018 March | 65 | 4 | 69 |
2018 February | 108 | 5 | 113 |
2018 January | 45 | 9 | 54 |
2017 December | 115 | 9 | 124 |
2017 November | 37 | 6 | 43 |
2017 October | 32 | 6 | 38 |
2017 September | 34 | 11 | 45 |
2017 August | 34 | 10 | 44 |
2017 July | 39 | 11 | 50 |
2017 June | 38 | 17 | 55 |
2017 May | 35 | 12 | 47 |
2017 April | 39 | 13 | 52 |
2017 March | 14 | 5 | 19 |
2017 February | 30 | 3 | 33 |
2017 January | 18 | 8 | 26 |
2016 December | 35 | 11 | 46 |
2016 November | 39 | 22 | 61 |
2016 October | 52 | 28 | 80 |
2016 September | 50 | 9 | 59 |
2016 August | 57 | 11 | 68 |
2016 July | 43 | 25 | 68 |
2016 February | 1 | 0 | 1 |
2015 December | 2 | 0 | 2 |
2015 June | 0 | 5 | 5 |
2014 June | 3 | 0 | 3 |
2014 March | 1 | 0 | 1 |
2013 September | 1 | 0 | 1 |
2013 August | 4 | 0 | 4 |
2013 July | 7 | 0 | 7 |