Is it Safe to Extubate Patients Overnight?

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Mechanical ventilation can be a life-saving intervention for some critically ill patients, but it is associated with significant complications. Efforts to shorten durations of mechanical ventilation to mitigate against these morbidities, especially in the current climate of heightened staffing of US intensive care units overnight, may make overnight extubation more commonplace. Understanding the safety and effectiveness of this practice is, therefore, of paramount importance. The published literature that informs this issue is limited to 2 retrospective studies published in 2016 with inconsistent findings. In this perspective, I will review this literature, consider its interpretation, explore the next steps, and, finally, describe my current practice to address the following question: “Is it safe to extubate patients overnight?”

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