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Meta-Analysis
. 2016 Jul-Aug;45(4):363-71.
doi: 10.1016/j.hrtlng.2016.04.006.

The effect of reintubation on ventilator-associated pneumonia and mortality among mechanically ventilated patients with intubation: A systematic review and meta-analysis

Fan Gao  1 , Li-Hong Yang  1 , Hai-Rong He  1 , Xian-Cang Ma  2 , Jun Lu  1 , Ya-Jing Zhai  3 , Li-Tao Guo  4 , Xue Wang  4 , Jie Zheng  5
Affiliations
Meta-Analysis

The effect of reintubation on ventilator-associated pneumonia and mortality among mechanically ventilated patients with intubation: A systematic review and meta-analysis

Fan Gao et al. Heart Lung. 2016 Jul-Aug.

Abstract

Objectives: This meta-analysis summarized the risks that reintubation impose on ventilator-associated pneumonia (VAP) and mortality.

Background: Extubation failure increases the probability of poor clinical outcomes pertaining to mechanical ventilation.

Methods: Literature published during a 15-year period was retrieved from PubMed, Web of Knowledge databases, the Embase (Excerpa Medica database), and the Cochrane Library. Data involving reintubation, VAP, and mortality were extracted for a meta-analysis.

Results: Forty-one studies involving 29,923 patients were enrolled for the analysis. The summary odds ratio (OR) between VAP and reintubation was 7.57 (95% confidence interval [CI] = 3.63-15.81). The merged ORs for mortality in hospital and intensive care unit were 3.33 (95% CI = 2.02-5.49) and 7.50 (95% CI = 4.60-12.21), respectively.

Conclusions: Reintubation can represent a threat to survival and increase the risk of VAP. The risk of mortality after reintubation differs between planned and unplanned extubation. Extubation failure is associated with a higher risk of VAP in the cardiac surgery population than in the general population.

Keywords: Extubation failure; Mortality; Reintubation; Ventilator-associated pneumonia.

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