Out-of-bed extubation in sedentary position possible? Case report

Abstract
Introduction: The withdrawal of ventilatory support is usually carried out in bed; sometimes patients can be extubated outside the usual sitting position in special cases; benefiting early mobilization which is associated with reducing hospital stay and improving functionality. Case description: 39-year-old female patient diagnosed with chronic kidney disease and requiring dialysis in the context of ventilatory failure due to emergency orotracheal intubation, after a favorable evolution, early mobilization is initiated and she is released from ventilatory support in a chair. Conclusion: Out-of-bed release so far has not been associated with complications, in our case it was successfully achieved avoiding unnecessary bed rest.
Keywords: Early mobilization; Mechanical ventilation; Intensive care; Weaning; Tracheal
extubation.

摘要
引言：呼吸支持撤除通常在卧床状态下进行；在特殊情况下，患者有时可以在非常规坐姿下拔除气管导管；这有利于早期活动，与缩短住院时间和提高功能相关。病例描述：一名39岁女性患者，患有慢性肾脏病，在因紧急气管插管导致的呼吸衰竭背景下需要进行透析，在病情好转后，启动早期活动，并在椅子上撤除呼吸支持。结论：截至目前，床旁拔管尚未与并发症相关，在我院病例中，这一操作成功完成，避免了不必要的卧床休息。
关键词：早期活动；机械通气；重症监护；脱机；气管拔管。