Management prior to extubation
Preventing extubation failure needs to optimize patient
prior to extubation so as to address the causes of
extubation failure which are similar to the causes of
weaning failure mentioned earlier with fluid balance and
cardiac dysfunction being of more significance in COPD.
Left ventricular heart failure and/or fluid overload is the
recognized cause for extubation failure as and biomarkers
such as BNP or NT‑proBNP may play a role in optimizing
fluid therapy prior to extubation.[33] Patient’s own
confidence predicts success in 90% versus 45% in patients
not confident about their own extubation.[