Currently available studies that compared post-extubation complications in subjects managed with the positive-pressure and suctioning techniques were summarized. Further high-quality studies with a robust study design and large sample sizes are warranted.

This study had some limitations.

428-30 of the 7 studies included in the systematic review had a high or serious risk of bias.

Because 328-30 of these high or serious risk studies were conducted in the operating room, the results with regard to extubation in the operating room should be interpreted carefully.

Although almost no difference was noted in the suctioning technique used among all studies, differences were noted in the positive-pressure technique between the operating room and ICU studies.

Namely, as positive-pressure technique, manual inflation was used in the operating room studies and mechanical PEEP was used in the ICU studies.

Because there have been no studies that compared differences between these positive-pressure techniques, it remains unknown whether they can be treated as the same techniques.

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