Delayed Extubation of Ventilator Tubes in Patients May Increase Health Risks

Recent research from the University of Michigan Medical School highlights a concerning trend in critical care: a significant number of patients remain connected to ventilator breathing tubes even after passing spontaneous breathing trials (SBTs), which are designed to assess whether a patient can breathe independently. The study reveals that approximately one in three hospitalized patients are not immediately extubated following a successful SBT, with many remaining on ventilators for an average of two additional days. While doctors sometimes delay extubation for safety reasons, such delays can increase the likelihood of complications like pneumonia, lung injury, and prolonged sedation.

Patients are typically intubated during surgeries or emergencies to secure airways and support breathing. However, prolonged intubation is associated with risks, and guidelines recommend performing SBTs to determine if patients can breathe without assistance. During an SBT, ventilator settings are gradually decreased over a period of 30 minutes to several hours, monitoring the patient’s stability.

The study, led by Dr. Anna Barker and Dr. Michael Sjoding, analyzed electronic health records from over 3,000 patients between 2015 and 2023. Results showed that 62.3% of patients who successfully passed an SBT were extubated within six hours, but the remaining patients faced delays. Factors like low consciousness levels, use of vasopressor medications, or recent procedures were known barriers to timely extubation, but more than half of the delayed cases had none of these factors. In these cases, patient or caregiver preference was often cited as a reason for delay, underscoring the need for further research to understand these decisions.

The study emphasizes the importance of effective communication among healthcare providers and families to optimize extubation timing. Intriguingly, the involvement of family members appears to promote greater alertness and may facilitate earlier extubation in suitable cases. These findings highlight the critical balance between ensuring safety and minimizing unnecessary ventilator-associated risks, with future efforts aimed at standardizing best practices for extubation to improve patient outcomes.

For more details, see the full study published in the Annals of the American Thoracic Society: [DOI: 10.1513/AnnalsATS.202502-188OC].

Source: https://medicalxpress.com/news/2025-07-ventilator-tube-delayed-patients-posing.html