A New Method for Extubation: Comparison between Conventional and New Methods

BACKGROUND: Extubation is associated with the risk of complications such as accumulated secretion above the endotracheal tube cuff, eventual atelectasia following a reduction in pulmonary volumes because of a lack of physiological positive end expiratory pressure, and intra-tracheal suction. In order to reduce these complications, and, based on basic physiological principles, a new practical extubation method is presented in this article. METHODS: The study was designed as a six-month prospective cross-sectional clinical trial. Two hundred fifty-seven patients undergoing coronary artery bypass grafting (CABG) were divided into two groups based on their scheduled surgery time. The first group underwent the conventional extubation method, while the other group was extubated according to a new described method. Arterial blood gas (ABG) analysis results before and after extubation were compared between the two groups to find the effect of the extubation method on the ABG parameters and the oxygenation profile. RESULTS: In all time intervals, the partial pressure of oxygen in arterial blood / fraction of inspired oxygen (PaO(2)/FiO(2)) ratio in the new method group patients was improved compared to that in the conventional method; some differences, like PaO(2)/FiO(2) four hours after extubation, were statistically significant, however (p value=0.0063). CONCLUSION: The new extubation method improved some respiratory parameters and thus attenuated oxygenation complications and amplified oxygenation after extubation.