Trial reportCritical care (London, England)2026
Effect of the extubation predictive score (ExPreS) on reintubation in the ICU: a randomized controlled trial.
Trial report in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05085457 (The Use of ExPreS - Extubation Predictive Score - in the Weaning of Patients in Invasive Mechanical Ventilation), which is not on this map. Cited by 1 paper.
What it found
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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.
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.
The Use of ExPreS - Extubation Predictive Score - in the Weaning of Patients in Invasive Mechanical Ventilation: a Randomized Clinical Trial
Who cites it
1 citing paper in PubMed.
- Liberation from Mechanical Ventilation in Acute Hypoxemic Respiratory Failure or Adult Respiratory Distress Syndrome: A Review.Journal of clinical medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtubation failure occurs in 10-30% of critically ill patients who successfully complete a spontaneous breathing trial (SBT) and is associated with worse clinical outcomes. The Extubation Predictive Score (ExPreS) was developed to assist clinicians in identifying patients at risk for extubation failure; however, its effectiveness as a decision-support tool has not yet been evaluated in a randomized controlled trial. We aimed to determine whether the use of ExPreS reduces reintubation within 48 h in mechanically ventilated adults.
methodsWe conducted a single-center, parallel-group, prospective, randomized, controlled superiority trial in two ICUs of a Brazilian university hospital (November 2021-December 2024). Adults ventilated ≥ 24 h who passed an SBT were randomized (1:1) to extubation guided by a standard protocol or by the ExPreS algorithm (score range 0-100; eight clinical variables). The primary outcome was extubation failure, defined as reintubation within 48 h. Secondary outcomes included duration of mechanical ventilation, ICU length of stay, and ICU mortality.
resultsA total of 540 patients were randomized (267 control, 273 ExPreS). In the intention-to-treat analysis, extubation failure within 48 h occurred in 13.0% of patients in the control group and 8.0% in the ExPreS group (absolute risk reduction 5.0%; relative reduction 38%; p = 0.070). In the per-protocol analysis, extubation failure occurred in 12.9% of controls and 7.3% of ExPreS patients (absolute risk reduction 5.6%; relative reduction 43%; p = 0.042). In a post-hoc analysis excluding airway obstruction, failure was further reduced with ExPreS (3.4% vs. 9.1%; p = 0.011). No differences were observed in duration of mechanical ventilation, ICU length of stay, or ICU mortality.
conclusionIn this randomized controlled trial, use of the Extubation Predictive Score (ExPreS) was associated with numerically lower rates of reintubation within 48 h compared with standard care, although the primary intention-to-treat analysis did not reach statistical significance. Secondary and exploratory analyses showed a consistent direction of effect. These findings should be interpreted cautiously and warrant confirmation in larger multicenter studies.
trial registrationregistered in ClinicalTrials.gov on October 07, 2021(NCT05085457).
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