In a large single centre study, 21% of intubated patients who received infusions of vasoactive infusions while mechanically ventilated were extubated for the first time while still receiving them. Coincident with their earlier extubation, these patients’ ICU length of stay was shorter without an increase in ICU mortality, hospital mortality or reintubation rate, suggesting that this can be safe practice, according to the study to appear in the American Journal of Respiratory and Critical Care Medicine.

The findings “suggest that current U.S. clinical trial practice and guidelines may be unnecessarily conservative. In the modern era of lung protective ventilation and reduced sedation, patients may be otherwise ready to extubate prior to full return of haemodynamic stability. Contrary to current practice in recent and ongoing U.S. clinical trials, these data suggest it may be safe to do so in select situations,” the study says.

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