Extubating patients as soon as possible is recommended to prevent adverse physical and cognitive outcomes. Hemodynamic stability is often listed as a criterion for extubation; however, the evidence is conflicting regarding the safety of extubation while the patient is receiving vasopressor medications. In addition, little is known about actual bedside practice in such situations.

Costa and colleagues surveyed clinicians to examine their reported practice of extubation with patients receiving vasopressor therapy. They found

  • One-third of respondents stated that they would extubate a patient receiving a continuous infusion of vasopressors.

  • About one-quarter reported that it would depend on the type of medication being used.

  • Almost 58% stated that their unit did not have a protocol or that they did not know if there was a protocol for this practice.

  • Clinicians working in a surgical intensive care unit (ICU) and those who provide direct patient care at least 50% of the time...

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