Tracheal extubation can evoke an equally strong haemodyamic stress response as tracheal intubation. We present a patient with myocardial infarction who repeatedly failed tracheal extubation. He developed acute pulmonary oedema following each attempt at tracheal extubation due to sympathetic overactivity. A change of approach with extubation under propofol sedation followed by continued sympatholysis with dexmedetomidine infusion allowed successful extubation.
No takes yet. Share an insight, caveat, or question.
Kulkarni et al. (2004) studied this question.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: