Which of the following groups of patients are considered at risk for reintubation?

1. Patients with APACHE 2 score greater than 12 on the day of extubation
2. Patients older than 45 years
3. Patients with congestive heart failure (CHF)
4. Patients with one or more weaning failure
a. 1 and 3 only
b. 1, 3, and 4 only
c. 2 and 4 only
d. 2, 3, and 4 only

ANS: B
Overall, patients at risk were defined as those with chronic obstructive pulmonary disease (COPD) or CHF, ineffective cough and excessive secretions, one or more weaning failure, one or more comorbid condition, upper airway obstruction, age older than 65 years, and APACHE 2 score of greater than 12 on the day of extubation.