Irene YUNIAR, Daendy Nova SETIA, Devina JUNE
Turkish Archives of Pediatrics - 2026;61(3):241-245
Objective: Mechanical ventilation is a common intervention in the pediatric intensive care unit (PICU). Identifying readiness for extubation in patients on mechanical ventilation is essential. However, predicting the right timing for weaning and extubation in the pediatric population remains challenging for clinicians. Extubation failure is associated with higher mortality, prolonged duration of mechanical ventilation, and longer hospital stays. This study aims to determine the clinical characteristics of patients with extubation failure in the PICU. Materials and Methods: This observational cross-sectional study included pediatric patients aged 1 month to 18 years who were admitted to the PICU and treated with a mechanical ventilator from January to May 2024. Inclusion criteria are patients with a mechanical ventilator who are eligible for the weaning process and ready for the extubation readiness test. Patients with incomplete data and do-not-resuscitate status were excluded from this study. Results: This study included 112 pediatric patients, aged 1 month to 18 years, who received mechanical ventilators. Extubation failure occurred in 29 patients (25.9%), with 8 patients requiring reintubation and 21 patients requiring noninvasive ventilation. Most participants were younger than 1 year (39.3%), with surgical cases being the leading cause of intubation (61.6%) in the PICU. This study found that extubation failure is associated with younger age (P = .008), patients with pneumonia (P < .001), and longer duration of mechanical ventilation (P = .041). Conclusion: Pediatric patients with critical illness experienced 25.9% extubation failure in the PICU. Patients with a medical indication for intubation and prolonged duration of mechanical ventilation were significantly associated with extubation failure.
