Evidence mapPaperPMID 37306270Full record

Trial reportAnaesthesiology intensive therapy2023

Comparison of positive pressure extubation with traditional extubation in critically ill patients - a randomised control study.

Ajeetviswanath Thanjavur Prabhakaran, Darlong Vanalal, Kapil Soni, Dalim Baidya, Richa Aggarwal, Harsha Binu, Shivanand Gamanagatti, Maya Dehran, Anjan Trikha

Open access · diamondAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Anaesthesiology intensive therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Ajeetviswanath Thanjavur PrabhakaranDepartment of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Darlong VanalalDepartment of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Kapil SoniCritical and Intensive Care, JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
Dalim BaidyaDepartment of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Richa AggarwalCritical and Intensive Care, JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
Harsha BinuDepartment of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Shivanand GamanagattiDepartment of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Maya DehranDepartment of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Anjan TrikhaDepartment of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
All India Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTwo extubation methods are commonly used in the intensive care unit (ICU): the traditional method with endotracheal suctioning and the positive- pressure method without suctioning. Better physiological outcomes were found in lab studies using the latter, as the air passing between the endotracheal tube and the larynx pushes out the collected subglottic secretions, which can be suctioned.

methods70 mechanically ventilated patients in a tertiary ICU were randomised into 2 groups of 35 patients each. At the end of the spontaneous breathing trial (SBT), the positive pressure extubation (PPE) group was given a pressure support of 15 cm H 2 O and a positive end expiratory pressure of 10 cm H 2 O for 5 minutes while the other group (traditional extubation - TE) was extubated directly. We compared the lung ultrasound scores (LUS), chest X-ray findings, alveolar arterial oxygen gradient changes, adverse clinical events, ICU-free days and reintubation rates between the two groups.

resultsMedian LUS at the end of the SBT was similar between the two groups. However, the median post-extubation LUS at 30 minutes, 6 hours, 24 hours in the PPE group [5 (4-8) ( P = 0.04), 5 (3-8) ( P = 0.02), 4 (3-7) ( P = 0.02), respectively] were significantly lower compared to the TE group [6 (6-8), 6 (5-7.5), 6 (5-7.5), respectively]. There was a persistent lowering of the scores even at the end of 24 hours in the PPE group, while the percentage of patients without adverse clinical events was significantly higher (80% vs. 57.14%, P = 0.04).

conclusionsThe study shows that positive pressure extubation is a safe procedure which improves aeration and reduces adverse events.

Indexed as

Airway ExtubationCritical IllnessHumansIntensive Care UnitsIntubation, IntratrachealOxygenOxygenlung ultrasoundmechanical ventilationpositive pressure extubationtraditional extubation

Identifiers

PMID37306270
PMCPMC10156539
OpenAlexW4352998780

What Socratic holds

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LicenceCC BY-NC-SA
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.