Prevalence and Predictors of Extubation Failure in PICU of Tertiary Care Hospital Hospital of Karachi

Afshan Asif; Murtaza Ali Gowa; Aasma Kayani; Hira Nawaz; Uzma Siddique

doi:10.70749/ijbr.v3i9.2417

Authors

Afshan Asif Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan
Murtaza Ali Gowa Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan
Aasma Kayani Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan
Hira Nawaz Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan
Uzma Siddique Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i9.2417

Keywords:

Extubation failure, pediatric intensive care, mechanical ventilation, risk factor, respiratory illness

Abstract

Objective: This study aimed to determine the prevalence and predictors of extubation failure among pediatric patients receiving invasive mechanical ventilation (IMV) in the Pediatric Intensive Care Unit (PICU) of a tertiary care hospital in Karachi, Pakistan. Methodology: A descriptive cross-sectional study was conducted at the National Institute of Child Health (NICH), Karachi, enrolling 98 children aged 1 month to 12 years who received IMV >24 hours. Data on demographic, clinical, and ventilatory parameters were collected. Extubation failure was defined as the need for re-intubation within 48 hours of planned extubation. Statistical analysis was performed using SPSS version 26, with a p-value <0.05 considered significant. Results: The overall prevalence of extubation failure was 18.4%. Younger age (<2 years), prolonged IMV duration, post-extubation stridor, and the need for non-invasive ventilation (NIV) after extubation were significant predictors of failure (p<0.05). The majority of extubation failures (72.2%) occurred within 24 hours of extubation. Respiratory illnesses were the most common primary diagnosis (57.1%), followed by sepsis (20.4%) and neurological disorders (12.2%). The overall mortality rate was 9.2%, with more than half of the deaths occurring in patients who experienced extubation failure. Conclusion: Extubation failure has been a major clinical issue within the pediatric critical care setting, especially in younger children and those with a history of long-term ventilation or airway complications. Enhancing the state of extubation readiness evaluation, the use of specific airways management, and the implementation of post-extubation monitoring are critical steps to achieving better results under the conditions of resource limitation.

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