Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke

Introduction. Stroke patients often meet respiratory guidelines for extubation, but uncertainty exists if patients will protect their airway due to impaired mental status. Patients with middle cerebral artery (MCA) acute ischemic stroke (AIS) might have specific predictors of successful extubation....

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Main Authors: Linda C. Wendell, Jonathan Raser, Scott Kasner, Soojin Park
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Stroke Research and Treatment
Online Access:http://dx.doi.org/10.4061/2011/248789
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author Linda C. Wendell
Jonathan Raser
Scott Kasner
Soojin Park
author_facet Linda C. Wendell
Jonathan Raser
Scott Kasner
Soojin Park
author_sort Linda C. Wendell
collection DOAJ
description Introduction. Stroke patients often meet respiratory guidelines for extubation, but uncertainty exists if patients will protect their airway due to impaired mental status. Patients with middle cerebral artery (MCA) acute ischemic stroke (AIS) might have specific predictors of successful extubation. Methods. Retrospective cohort of MCA AIS patients requiring intubation. Results. Thirty-seven MCA AIS patients were extubated successfully and ten failed extubation. Those who successfully extubated had higher extubation composite and eye response Glasgow Coma Scale (GCS) scores compared to those who failed (median 10T (IQR 9T–11T) versus 9.5T (8T–10T), 𝑃=0.047, and 4 (3-4) versus 2.5 (1–3), 𝑃<0.01). When adjusted for age, admission National Institutes of Health Stroke Scale score and laterality, patients with a GCS score ≥8T trended toward extubating successfully (OR 23.30 (CI 0.94–580.27), 𝑃=0.055). Conclusions. The GCS score might be important in predicting successful extubation in MCA AIS patients. Further prospective study is warranted to better assess factors predictive of extubation outcome in stroke and other brain-injured patients.
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spelling doaj-art-e364ed22b1f645eb823dd788ebed0bb52025-08-20T02:21:24ZengWileyStroke Research and Treatment2042-00562011-01-01201110.4061/2011/248789248789Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic StrokeLinda C. Wendell0Jonathan Raser1Scott Kasner2Soojin Park3Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, RI 02903, USADepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USADepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USADepartments of Neurology, Neurosurgery, and Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USAIntroduction. Stroke patients often meet respiratory guidelines for extubation, but uncertainty exists if patients will protect their airway due to impaired mental status. Patients with middle cerebral artery (MCA) acute ischemic stroke (AIS) might have specific predictors of successful extubation. Methods. Retrospective cohort of MCA AIS patients requiring intubation. Results. Thirty-seven MCA AIS patients were extubated successfully and ten failed extubation. Those who successfully extubated had higher extubation composite and eye response Glasgow Coma Scale (GCS) scores compared to those who failed (median 10T (IQR 9T–11T) versus 9.5T (8T–10T), 𝑃=0.047, and 4 (3-4) versus 2.5 (1–3), 𝑃<0.01). When adjusted for age, admission National Institutes of Health Stroke Scale score and laterality, patients with a GCS score ≥8T trended toward extubating successfully (OR 23.30 (CI 0.94–580.27), 𝑃=0.055). Conclusions. The GCS score might be important in predicting successful extubation in MCA AIS patients. Further prospective study is warranted to better assess factors predictive of extubation outcome in stroke and other brain-injured patients.http://dx.doi.org/10.4061/2011/248789
spellingShingle Linda C. Wendell
Jonathan Raser
Scott Kasner
Soojin Park
Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke
Stroke Research and Treatment
title Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke
title_full Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke
title_fullStr Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke
title_full_unstemmed Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke
title_short Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke
title_sort predictors of extubation success in patients with middle cerebral artery acute ischemic stroke
url http://dx.doi.org/10.4061/2011/248789
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AT scottkasner predictorsofextubationsuccessinpatientswithmiddlecerebralarteryacuteischemicstroke
AT soojinpark predictorsofextubationsuccessinpatientswithmiddlecerebralarteryacuteischemicstroke