Does Tracheal Suction During Extubation in Intensive Care Unit Decrease Functional Residual Capacity

Little is known about the procedure of extubation of patients admitted in Intensive Care Units (ICU). In particular, effects of tracheal suction during extubation have never been evaluated. Tracheal suction induces alveolar derecruitment in sedated patients under mechanical ventilation and is a major source of pain. The aim of this study was to evaluate the impact of tracheal suction during the extubation procedure of critically ill patients on the end-expiratory lung volume.

Inclusion Criteria: * age of 18 years or more * hospitalization in the surgical ICU (whatever the cause of hospitalization) * under mechanical ventilation via a tracheal tube (oro or nasotracheal) for at least 24 hours * satisfying general criteria for mechanical ventilation weaning (described by the French Language Resuscitation Society) * having successfully completed a spontaneous breathing trial (among those described by the SRLF) * physiotherapist available during the first hour after extubation Exclusion Criteria: * the presence of an electrical implantable medical device (pacemaker, automatic defibrillator, deep brain stimulation box) * body mass index (BMI) \> 50 * pregnancy * tracheal tube with subglottic suction channel * technical impossibility of monitoring by electrical impedance tomography (chest plaster, undrained pneumothorax, ...).