Anesthesiology & Pain Medicine >> Research >> Focus Areas >> Outcomes >> Extubation Failure in Patients with Difficult Airways Study
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Research Focus Areas:

Extubation Failure in Patients with Difficult Airways Study

Principal Investigators

M. M. Treggiari, M.D., Ph.D., M.P.H.


There is little information on the approach to removal of endotracheal tube in patients with difficult airway. Data on the circumstances, techniques and safety of extubation strategies are also lacking. An evaluation of difficult airway management within the Closed Claim project identified severe injuries occurring among patient requiring re-intubation after failed extubation, and concluded that the development of management strategies covering emergence and the recovery phase post-extubation may improve patient safety 1. Requirement for re-intubation after surgical procedures involved neck swelling with respiratory distress after cervical fusion and other neck surgeries, or fluid extravasation from a central catheter. Interestingly, most of the claims from extubation failure were in cases of potentially predictable difficulties including difficult intubation on induction, obesity and/or sleep apnea.

Patients with a known or suspected difficult airway and at high risk of extubation failure represent a patient cohort who requires careful monitoring and may benefit from a planned extubation strategy involving reversible extubation.

The primary aims of the present study are to: (1) investigate the occurrence of extubation failure in a population of intubated patients requiring ICU admission; (2) identify subgroups of patients with anticipated and known difficult airways; (3) estimate the size of the population with difficult reintubation; and (4) the incremental cost associated with extubation failure. Secondary aims include the evaluation of the circumstances, techniques and complications of re-intubation.

Research Projects

A Nursing Study of Gut Function in Menstruating Women
M. M. Heitkemper, Ph.D., M. E. Jarrett, Ph.D., P. G. Richebé, M.D., Ph.D.
Abdominal Symptom Phenotypes: Pathways to New Biomarkers
M. M. Heitkemper, Ph.D., R. Shulman, M.D., P. G. Richebé, M.D, Ph.D., et al.
Closed Claims Project
K. Domino, M.D., MPH, K. Posner, Ph.D., F.W. Cheney, M.D., L. Lee, M.D.
Computerized Glucose Control in Critically Ill Patients
M. Horibe, M.D., J.D. Lang, M.D., B. G. Nair, Ph.D.
Determination of Risk Factors for Ischemic Optic Neuropathy After Spine Surgery
Lorri A. Lee, M.D.K., Domino, MD,MPH, K. Posner, PhD, et al.
Extubation Failure in Patients with Difficult Airways Study
M. M. Treggiari, M.D., Ph.D., M.P.H.
lst Tier Drugs + Theophylline In Pediatric Severe Asthma
J. Zimmerman, M.D., D. Jardine, M.D.
Pharmacokinetics of Intrathecal Drug Infusions
C.M. Bernards, MD, S. Flack, MBChB
Real-Time Electronic Alerts to Improve Antibiotic and Temperature Management in Surgical Patients
B. G. Nair, Ph.D., H. A. Schwid, M.D.
Resource Over Utilization due to Serious Alcohol Related Injuries (CR)
J. Jarvik, M.D., M.P.H., B.S. Roudsari, Ph.D., M.S. Vavilala, M.D., B. Bresnahan, Ph.D
SIDS and the Inner Ear: A Follow up study of Hearing, Vestibular Function and Respiratory Control
D. Rubens, M.D.
The Association Between Innate Immunity Genes and Outcome Following Sepsis in Children
J. H. Kim, M.D., G. P. Jarvik, M.D., D. Jardine, M.D.
The Gas Study: Comparing Neurodevelopment Outcome and Apnea in Infants
M.E, McCann, M.D., A. Lynn, M.D.
The Influence of Inhaled Nitric Oxide on Attenuating Hepatic Sinusoidal Leukocyte-Endothelial Interactions in Patients Undergoing Orthopic Liver Transplantation
J.D. Lang, Jr, M.D.
Use of Transthoracic Ultrasound to Triage Patients in Preanesthesia Clinic
E. Wako, M.D., G. Van Norman, M.D., G.A. Rooke, MD., Ph.D.