Timing of Extubation is Important in Patients with Acute Brain Injury

By admin, 29 April, 2025

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A study published in the American Journal of Respiratory and Critical Care Medicine reported more ventilator-free days with prompt extubation post-successful spontaneous breathing trials in patients with acute brain injury.

Limited information exists related to the association of extubation timing (prompt or not prompt) and clinical benefits in patients with acute brain injury after a successful spontaneous breathing trial.

The study determined the link between the immediate attempt to extubate and ventilator-free days in patients with acute brain injury.

The researchers analyzed the data obtained from the Toronto Intensive Care Observational Registry. The study included patients diagnosed with acute brain injury on mechanical ventilation and had a successful spontaneous breathing trial. The primary endpoint of the study was ventilator-free days of ≤28 days.

The study included 1406 patients. The primary reasons for admission were stroke, traumatic brain injury, subarachnoid hemorrhage, and seizures. Prompt extubation was reported in >50%. The study reported an association between prompt extubation and higher ventilator-free days (incidence rate ratio, 1.24) than patients without prompt extubation. 

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Key highlights
  • The study focused on adults with acute brain injury receiving invasive mechanical ventilation.
  • Prompt extubation after the first successful spontaneous breathing trial leads to more ventilator-free days.
Source

Angriman F, Amaral ACKB, Fan E, et al. Timing of Extubation in Adult Patients with Acute Brain Injury. Am J Respir Crit Care Med. 2025;211(3):339-346. doi:10.1164/rccm.202408-1553OC

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Short Description

The study determined the link between the immediate attempt to extubate and ventilator-free days in patients with acute brain injury.

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