Frutos-Vivar et al used a number of indicators to decide when to reintubation a patient following extubation. The authors are from multiple institutions in Argentina, Brazil, Columbia, Saudi Arabia, Spain, the United States and Venezuela.
Indicators for reintubation - one or more of the following:
(1) lack of improvement or worsening of arterial pH (usually acidosis)
(2) lack of improvement or rising PaCO2
(3) decreased mental status
(4) decrease in oxygen saturation to < 85% despite use of high FIO2
(5) lack of improvement or worsening in signs of respiratory muscle fatigue
(6) hypotension (systolic blood pressure < 90 mm Hg) for > 30 minutes despite adequate volume loading
(7) use of vasopressors to maintain blood pressure
(8) copious secretions that cannot be adequately cleared by the patient
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