Research Finds One in Three Hospitalized Patients Remain Intubated Past When Is Necessary

New research from the University of Michigan Medical School found that “one in three hospitalized patients remain connected to a breathing tube after passing a spontaneous breathing trial.”

Delays in removal are sometimes necessary, but “being connected to a breathing tube increases the risk for ventilator-associated complications,” like pneumonia, lung injury, and prolonged sedation. Intubation is often provided to patients “as a life saving measure to protect their airways and facilitate breathing.”

Spontaneous breathing trials are a “guideline-recommended method that help determine whether a patient can breathe on their own following mechanical ventilation.” During one of these trials, “ventilator settings are minimized for a period of 30 minutes to three hours to see whether a patient’s heart rate and breathing are stable.” The research team “sought to determine how many patients who pass this trial are extubated within six hours and what factors were associated with staying connected to the ventilator.”

Electronic health record data from over 3,000 patients showed that “62.3% of patients were extubated within six hours following a successful SBT,” and patients who weren’t extubated “spent an average of two additional days on the ventilator.” More than half of the patients had no factors known to be associated with remaining on the ventilator for safety considerations. The most common reason provided for non-removal among these patients was “attending preference, which needs more research to better understand.”