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Stroke Research and Treatment
Volume 2011 (2011), Article ID 248789, 5 pages
Research Article

Predictors of Extubation Success in Patients with Middle Cerebral Artery Acute Ischemic Stroke

1Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
2Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
3Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA

Received 14 April 2011; Revised 14 July 2011; Accepted 8 August 2011

Academic Editor: Chelsea S. Kidwell

Copyright © 2011 Linda C. Wendell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Stroke patients often meet respiratory guidelines for extubation, but uncertainty exists if patients will protect their airway due to impaired mental status. Patients with middle cerebral artery (MCA) acute ischemic stroke (AIS) might have specific predictors of successful extubation. Methods. Retrospective cohort of MCA AIS patients requiring intubation. Results. Thirty-seven MCA AIS patients were extubated successfully and ten failed extubation. Those who successfully extubated had higher extubation composite and eye response Glasgow Coma Scale (GCS) scores compared to those who failed (median 10T (IQR 9T–11T) versus 9.5T (8T–10T), 𝑃 = 0 . 0 4 7 , and 4 (3-4) versus 2.5 (1–3), 𝑃 < 0 . 0 1 ). When adjusted for age, admission National Institutes of Health Stroke Scale score and laterality, patients with a GCS score ≥8T trended toward extubating successfully (OR 23.30 (CI 0.94–580.27), 𝑃 = 0 . 0 5 5 ). Conclusions. The GCS score might be important in predicting successful extubation in MCA AIS patients. Further prospective study is warranted to better assess factors predictive of extubation outcome in stroke and other brain-injured patients.