REVIEW article
Front. Pediatr.
Sec. Pediatric Critical Care
Overnight Extubation and Risk of Extubation Failure in Pa-tients in the Pediatric Intensive Care Unit: An Exploratory Review
Provisionally accepted
- University of Santiago de Cali, Cali, Colombia
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Background/Objectives: Extubation in pediatric intensive care units (PICUs) requires care and thoroughness to minimize risks of extubation failure, systemic complications, and mortality. Up to 20% of patients in the PICU experience extubation failure, resulting in reintubation, longer hospital stays, and higher healthcare costs. Currently, no reviews have synthesized findings on the effect of overnight extubation and its association with extubation failure. Methods: This exploratory review was conducted based on the Joanna Briggs Institute methodology and PRISMA extension for scoping reviews guidelines. We analyzed studies collected from databases such as PubMed, Scopus, Web of Science, Science Direct, VHL Regional Portal, and Google Scholar using MeSH terms, Boolean oper-ators, and a search strategy based on population, concept, and context (PCC). Studies that evaluated the impact of overnight extubation in the PICU were included, with the primary outcome being the association with the risk of extubation failure. Results: T Results: Of 275 records identified, five studies met the inclusion criteria. Four studies found no significant association between overnight extubation and extubation failure, whereas one study with a larger sample reported a higher risk of reintubation during nighttime extubation. Overall, the findings revealed heterogeneous results influenced by population type, clinical context, and organizational factors. Conclusions: The available evidence does not consistently demonstrate that overnight extubation increases the risk of failure; however, some studies suggest that patient complexity and contextual factors may modify this relationship. Therefore, extubation decisions should be individualized according to clinical stability and available resources rather than based solely on the time of day, un-derscoring the need for prospective and standardized studies in this field.
Keywords: Pediatric intensive care units, tracheal extubation, Intratracheal intubation, artificial respiration, Extubation
Received: 06 Sep 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 Arzayus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Leonardo Arzayus, leonardoarzayus00@usc.edu.co
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.