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Research Snapshot Theater: Epidemiology - Outcomes, Pediatric I

Clinical Epidemiology of Extubation Failure in a PICU of a University Hospital

Sunday, March 22, 2026
9:45 AM - 10:45 AM Central Time
Location: Connections Central - RST 17
Introduction: Invasive mechanical ventilation (IMV) is a critical intervention that can save the lives of critically ill children. Extubation failure (EF), , remains a significant challenge. The risk is higher in children under 24 months, those with genetic conditions, respiratory or neurological illnesses, airway disorders, or low Glasgow Coma Scores. EF is associated with increased mortality, longer PICU stays, and greater family burden. Literature from developing countries with limited resources remains scarce. We aim to determine the epidemiology of EF in our PICU.


Methods: This prospective cohort study was conducted in a tertiary care university hospital. Children aged 1 month to 18 years admitted to PICU from 24th Nov 2023 to 15th March 2025, requiring IMV for >24 hours, were included. Patients with congenital disorders, tracheostomy, home ventilation, unplanned extubation, leaving against advice, or expiring before extubation were excluded. Data collection included demographics, diagnosis, intubation details, and EF (reintubation within 72 hours). Analysis used SPSS with descriptive statistics and chi-square tests.


Results: A total of 910 patients were admitted to the PICU during the study period, 314 required IMV, and 245 were included. Mean age was 50.18 ± 55.81 months. Admitting diagnosis included neurological diseases 13.9%(n=34), respiratory diseases 13.4%(n=33), post-cardiac surgery 13.4%(n=33), and infections 13.1%(n=32). EF occurred in 15.9%(n=39) cases: 35.9%(n=14) within 12 hours, 38.4%(n=15) within 12–24 hours, and 25.6%(n=10) between 24–48 hours. PICU and hospital length of stay was 8.96 ±7.83 days, 13.87±9.58 days respectively. Overall mortality 14.36% while among EF patients 35.9% expired. Inotropes and syndrome showed significant association with EF (RR 7 & RR 1.77 respectively with CI 95%).


Conclusions: Extubation failure in our cohort was 15.9% which is associated with prolonged hospitalization and high mortality.