الملخص الإنجليزي
Introduction: Failure to extubate refers to the inability to sustain spontaneous breathing
after removing an artificial airway within 48 hours of extubation. This is due to severe
respiratory distress caused by COVID-19 infection. The prevalence and predictors of
failure to extubate in COVID-19 patients can vary depending on several factors, including
the severity of the disease, characteristics of the patient population studied, and the specific
criteria used to define extubation failure. Treatment strategies can also significantly
influence outcomes.
Objectives: To assess the prevalence, possible predictors, and outcomes of failure to
extubate adult COVID-19 patients who were admitted to intensive care units in the
Sultanate of Oman.
Methods: This is a multi-center, cross-sectional, retrospective, case-control design study.
Patients (18 years or older) Adult COVID-19 patients who were invasively ventilated and
admitted to ICU in Sultan Qaboos University Hospital and Royal Hospital either
successfully extubated or not from February 2020 to February 2022, were included.
Results: The study included 356 patients. Of 356 patients, 25.6% (n = 91) failed to extubate,
and 74.4% (n = 265) were successfully extubated. Multivariate logistic regression analysis
showed increased odds of failure to extubate risks associated with comorbidities (p <
0.001), existing infection (OR = 0.226, 95% CI: 0.126 - 0.408; p < 0.001), length of
mechanical ventilation (OR = 0.048, 95% CI: 0.008 – 0.291, p <0.001), antiviral (OR =
0.192, 95% CI .071-0.519; p < 0.001). The results also showed that the oxygenation index
significantly predicted failure to extubate invasively ventilated patients with COVID-19
(OR = < 0.001, CI = .110 - 0.465, p < 0.01).
Conclusions: The prevalence of failure to extubate is 9.74 among adults ICU patients
ventilated invasively with Coronavirus who failed to extubate in this study. The study
demonstrates the importance of early intervention and prediction of failure to extubate
patients with coronavirus ARDS to prevent inpatient mortality and aims for early
intervention and management. All healthcare professionals can use the data provided here
to control and reduce the risk of failure to extubate and prevent complications.
