Abstract

Introduction: The 24-to-72-hour period post-extubation is a critical phase for intensive care patients, and can result in many complications. Nurses must be expertly trained in the interventions available to reduce the risks associated with the procedure.

Objectives: This systematic review aims to critically evaluate the existing literature about nursing interventions associated with patients after extubation, providing evidence to guide the nursing practice to reduce extubation failure, reintubation rates, and hospital stays.

Methodology: This systematic review includes studies from CINAHL, PubMed Central, Medline, and Health Source Nursing Academic Edition, focusing on international peer-reviewed full-text research articles.

Setting: The study has a sample size of 11,756, and it faces limitations with articles published before 2018 and the diversity of intensive care patients. Inclusion criteria involve adult intensive care patients aged ≥18 years who experienced extubation, and exclusion criteria included patients under this age and categorized as surgical patients.

Main outcome measures: It analyzes the efficacy in reduce post-extubation complications related to desaturation, secretion management, stridor/laryngeal edema and pneumonia.

Findings: When compared with standard care, studies have shown that high-flow nasal cannula and noninvasive ventilation has shown the potential to reduce extubation failure and reintubation rates. Mechanical insufflation-exsufflation effectively promotes airflow in ventilated patients to stimulate a cough, facilitating sputum expectoration. Effective oral hygiene plays a crucial role in preventing Ventilator-Associated Pneumonia, and steroids are efficient in prevent laryngeal edema/stridor.

Conclusion: Implementing these nursing interventions can significantly benefit adult intense care patients recently extubated, increasing their safety, reducing reintubation rates, and optimizing recovery.

Implications: When critical patients stays are prolonged, it can strain nursing resources and lead to higher nurse-patient ratios, compromising patient care. It requires nurses to become active participants in monitoring the extubation outcomes and implement strategies for further improvement of a national guideline and protocol for post-extubation care.

Notes

Reference list attached as a separate document file.

Description

This systematic review evaluates nursing interventions post-extubation to reduce complications, failure rates, and hospital stays. Analyzing 11,756 cases, it highlights effective strategies like high-flow nasal cannula, noninvasive ventilation, mechanical insufflation-exsufflation, oral hygiene, and steroids to prevent laryngeal edema. Findings suggest these interventions enhance patient safety, optimize recovery, and call for national guidelines to improve post-extubation care in ICUs.

Author Details

Estevao F. De Souza, BSN RN; Tricia M. Grinder, BSN, RN; Sarah Rigsby, BSN, RN; Samantha Vallespi, BSN, RN

Sigma Membership

Mu Iota

Type

Poster

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Other

Keywords:

Acute Care, Implementation Science, Testing Strategies, Promoting Clinical Outcomes, Intensive Care Patients, ICU Patients, Post-Extubation Period

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-12-09

Click on the above link to access the poster.

Additional Files

References.pdf (122 kB)

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Critical Nursing Interventions for Post-Extubation ICU Patients

Indianapolis, Indiana, USA

Introduction: The 24-to-72-hour period post-extubation is a critical phase for intensive care patients, and can result in many complications. Nurses must be expertly trained in the interventions available to reduce the risks associated with the procedure.

Objectives: This systematic review aims to critically evaluate the existing literature about nursing interventions associated with patients after extubation, providing evidence to guide the nursing practice to reduce extubation failure, reintubation rates, and hospital stays.

Methodology: This systematic review includes studies from CINAHL, PubMed Central, Medline, and Health Source Nursing Academic Edition, focusing on international peer-reviewed full-text research articles.

Setting: The study has a sample size of 11,756, and it faces limitations with articles published before 2018 and the diversity of intensive care patients. Inclusion criteria involve adult intensive care patients aged ≥18 years who experienced extubation, and exclusion criteria included patients under this age and categorized as surgical patients.

Main outcome measures: It analyzes the efficacy in reduce post-extubation complications related to desaturation, secretion management, stridor/laryngeal edema and pneumonia.

Findings: When compared with standard care, studies have shown that high-flow nasal cannula and noninvasive ventilation has shown the potential to reduce extubation failure and reintubation rates. Mechanical insufflation-exsufflation effectively promotes airflow in ventilated patients to stimulate a cough, facilitating sputum expectoration. Effective oral hygiene plays a crucial role in preventing Ventilator-Associated Pneumonia, and steroids are efficient in prevent laryngeal edema/stridor.

Conclusion: Implementing these nursing interventions can significantly benefit adult intense care patients recently extubated, increasing their safety, reducing reintubation rates, and optimizing recovery.

Implications: When critical patients stays are prolonged, it can strain nursing resources and lead to higher nurse-patient ratios, compromising patient care. It requires nurses to become active participants in monitoring the extubation outcomes and implement strategies for further improvement of a national guideline and protocol for post-extubation care.