Evidence mapPaperPMID 41821078Full record

Trial reportCritical care (London, England)2026

Effect of the extubation predictive score (ExPreS) on reintubation in the ICU: a randomized controlled trial.

Julia Almeida Oliveira, Fernanda Klein, Natália Godoy Guzatti, Ana Paula Fernandes Kojoroski, Herika de Vargas Ciello, David Junior da Silva, Jéssica Locatelli, Letícia Fiorelli da Silva, Marcella Parise, Arthur Vacchi Spörr and 6 more

Registry-linked trialAbstract readRandomized Controlled TrialEquivalence Trial
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
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.

NCT05085457 nacompletednot on this map

The Use of ExPreS - Extubation Predictive Score - in the Weaning of Patients in Invasive Mechanical Ventilation: a Randomized Clinical Trial

TypeinterventionalSponsorUniversidade do Oeste de Santa CatarinaRan2021 to 2024Enrolled540ConditionsRespiratory InsufficiencyArmsExPreS Protocol
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

16 authors.

Julia Almeida Oliveira *Universidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Fernanda Klein *Universidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Natália Godoy GuzattiUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Ana Paula Fernandes KojoroskiUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Herika de Vargas CielloUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
David Junior da SilvaUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Jéssica LocatelliUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Letícia Fiorelli da SilvaUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Marcella PariseUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Arthur Vacchi SpörrUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Wan Cley RabuskeUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Gustavo Bruno RáticoHospital Universitário Santa Terezinha - HUST, Joaçaba, SC, Brazil.
Silvano Altair do NascimentoHospital Universitário Santa Terezinha - HUST, Joaçaba, SC, Brazil.
Diego de CarvalhoUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
João Rogério Nunes FilhoUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil.
Antuani Rafael BaptistellaUniversidade do Oeste de Santa Catarina - UNOESC, Joaçaba, SC, Brazil. antuani.baptistella@unoesc.edu.br.ORCID http://orcid.org/0000-0003-1708-9921

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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).

Indexed as

Airway ExtubationIntubation, IntratrachealAgedBrazilFemaleHumansIntensive Care UnitsLength of StayMaleMiddle AgedPredictive Value of TestsProspective StudiesRespiration, ArtificialVentilator WeaningExtubationExtubation predictive score (ExPreS)Mechanical ventilationPredictors of extubation outcomeRandomized controlled trialWeaning

Identifiers

PMID41821078
PMCPMC13326370

What Socratic holds

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Registered trials

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.