Endotracheal extubation.

Over the last decade, investigators have increasingly focused on the process of translaryngeal extubation. Depending on the patient population studied, the frequency of extubation failure varies from 2% to 20%. The pathophysiology of extubation failure is distinct from that of weaning failure. Patients failing extubation have a high mortality, significant prolongation of mechanical ventilation, and longer duration of hospital stay. Commonly used weaning predictors are much less accurate in foretelling extubation outcome. Rapid reinstitution of either invasive or noninvasive ventilatory support has the potential to improve the outcome of extubation failure.