How I evaluate upper airways functions at the time of extubation (except laryngeal dyspnea)

Abstract

Weaning a patient from invasive artificial ventilation is a daily issue in our units. This process requires to ensure that this patient no longer requires ventilatory support, but also that it will tolerate removal of the invasive interface. Thus, in addition to the “general” risk factors for extubation failure that are not developed in this text, there is retained as a specific risk factor the existence of an insufficiently effective cough or swallowing disorders. Focusing on the potential pathophysiology of invasive ventilation, it is necessary to develop a specific approach to these risk factors for extubation failure, whether it is before or after extubation. We develop in this “expert practice” type manuscript our diagnostic and therapeutic approaches, which is based primarily on clinical elements, while building on current recommendations.