Background: Whereas ICU-acquired weakness may delay extubation in mechanically ventilated patients, its\ninfluence on extubation failure is poorly known. This study aimed at assessing the role of ICU-acquired weakness on\nextubation failure and the relation between limb weakness and cough strength.\nMethods: A secondary analysis of two previous prospective studies including patients at high risk of reintubation\nafter a planned extubation, i.e., age greater than 65 years, with underlying cardiac or respiratory disease, or\nintubated for more than 7 days prior to extubation. Patients intubated less than 24 h and those with a do-notreintubate\norder were not included. Limb and cough strength were assessed by a physiotherapist just before\nextubation. ICU-acquired weakness was clinically diagnosed as limb weakness defined as Medical Research Council\n(MRC) score < 48 points and severe weakness as MRC sum-score < 36. Cough strength was assessed using a semiquantitative\n5-Likert scale. Extubation failure was defined as reintubation or death within the first 7 days following\nextubation.\nResults: Among 344 patients at high risk of reintubation, 16% experienced extubation failure (56/344). They had\ngreater severity and lower MRC sum-score..............
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