Weaning protocols for discontinuation of invasive mechanical ventilation often mandate resolution of shock. Whether extubation while receiving vasopressors is associated with harm is uncertain.

To examine whether extubation while still receiving vasopressors is associated with worse outcomes.

We performed a retrospective cohort study of adults in Calgary ICUs who received vasopressors with invasive mechanical ventilation and an extubation attempt.

The primary exposure was continued vasopressor use at extubation.

The primary outcome was reintubation within 96-hours.

Secondary outcomes included in-hospital mortality and ICU/hospital length of stay (LOS).

We assessed associations of vasopressor use at extubation with outcomes using multivariable competing-risk (reintubation/LOS) and Cox proportional-hazards (mortality) models.

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