Unsuccessful extubation: its risks, complications and treatment

Karolina Buožytė1, Gabrielė Baltrūnaitė1, Ligita Bespalovaitė1

1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine


Tracheal extubation is not only an important indicator of a patient’s  improving condition in intensive care units or in the post-anesthesia period, but also is a high-risk procedure that can lead to a number of complications. Unsuccessful extubation and delayed reintubation are associated with increased mortality, additional medical costs, or mechanical ventilation problems. This article reviews the problem of unsuccessful extubation, its risk factors, complications, their treatment and prevention.  Such risk factors require that the extubation process is managed by professionals who have a thorough understanding of  extubation failure causes and potential complications. Summarizing the reviewed literature it was concluded that planning for tracheal extubation is a critical component of a successful airway management strategy, especially when dealing with situations where there is an increased risk of extubation failure. Proper planning requires identifying patients who have or may develop complications after extubation, identifying situations where there is an increased risk of airway damage,  understanding the causes and underlying mechanisms of extubation failure.

The aim of this review was to analyze tracheal extubation failure, its risk factors, possible causes, complications, their treatment and prevention.  Databases such as Pubmed, UpToDate and ScienceDirect were searched using the keywords “tracheal extubation”, “extubation risks”, “extubation failure”, “reintubation”, “complications”.

Keywords: tracheal extubation, extubation risks, extubation failure, reintubation, complications.