PRIMARY OUTCOMES AFTER EXTUBATION IN NEUROCRITICAL PATIENTS IN INTENSIVE CARE UNITS

Abstract

Introduction: Neurocritical patients require intensive care and require orotracheal intubation (OTI) and invasive mechanical ventilation (IMV). The management of these patients can be challenging and present extubation failure rates and lead to negative outcomes, such as tracheostomy and mortality. Objective: To characterize the profile and describe post-extubation outcomes in neurocritical patients admitted to the ICUs of an Emergency and Trauma Hospital. Methodology: This is a longitudinal, descriptive and prospective study with individuals aged 18 years and over, diagnosed with stroke and/or traumatic brain injury (TBI), admitted to ICUs, undergoing OTI and who have signed the authorization through the Free and Informed Consent Form. Results: A total of 205 patients were included, diagnosed with TBI 128 (62.5%), ischemic stroke 46 (22.4%) and hemorrhagic stroke 31 (15.1%), the majority of whom were male 156 (76.1%), with a median age of 54 years and a mortality rate of 51.2%. 33.7% were tracheostomized and 6.8% needed to be reintubated. Conclusion: This research was relevant because it characterized the profile of neurocritical patients in an emergency and trauma hospital and their outcomes. The study highlighted the predominance of men with TBI, high mortality and a substantial need for tracheostomy, in addition to prolonged hospital stay and low use of NIV, highlighting the complexity of care for neurocritical patients.
KEYWORDS: Respiration, artificial; Brain injuries; Critical care; Airway extubation.