DOI

10.21007/con.dnp.2026.0130

Faculty Advisor

Margaret Harvey, PhD, APRN, ACNP-BC, CHFN, FHRS

Subject Matter Expert

Tracy McClinton, DNP, APRN, AGACNP-BC, HGET-C, EBP-C

Clinical Site

Regional One Health

Document Type

Poster

Publication Date

Spring 4-2026

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Nursing Administration | Quality Improvement

Abstract

Keywords: dexmedetomidine, propofol, reintubation, sedation2

Abstract Assignment

Background

Sedation management in the ICU plays a key role in extubation readiness and post-extubation outcomes in mechanically ventilated patients. Although both propofol and dexmedetomidine are commonly used in critical care, there is limited evidence comparing their impact on early reintubation. This quality improvement (QI) project examined whether sedative choice was associated with reintubation within 48 hours of extubation.

Methods

A retrospective QI analysis was conducted in a cohort of 38 mechanically ventilated adult patients. Patients received either propofol (n = 31) or dexmedetomidine (n = 7) prior to extubation. Reintubation within 48 hours served as the primary outcome. Fisher’s exact test was used to evaluate the relationship between sedative type and reintubation. Secondary outcomes include time to extubation and hospital length of stay, which were analyzed using both parametric and nonparametric statical techniques according to underlying data distributions.

Considering the substantial group size imbalance between sedative cohorts, nonparametric analyses were prioritized where distributional assumptions for parametric testing were not met.

Results

Among the study population, 18.4% of patients required reintubation. Sedative selection demonstrated a statistically significant association with reintubation status (p=.013), with propofol use associated with a markedly lower likelihood of reintubation compared with dexmedetomidine (OR= 11.17). The median time to extubation was significantly shorter in the propofol cohort (18.50hours) relative to the dexmedetomidine cohort (207.12 hours; p+0.44_.

Although these findings persisted despite pronounced imbalance in cohort sizes, differences in3 mean time to extubate did not achieve statistical significance when evaluated using parametric methods.

Implications for Nursing Practice

Sedative choice may influence extubation outcomes. Propofol was associated with lower reintubation rates and shorter time to extubation. Nurse practitioners should collaborate in sedation planning and monitor patients closely post-extubation, However, unequal group sizes limit these findings. Sedatives selection should remain individualized based on patient-specific factors.

Additional Files
Albright_Armo_Barbee_Caty-Pletcher_Abstract.pdf (121 kB)
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