Do ICU Attending Handoffs Lead to Extra Days on the Ventilator?

When to extubate is a nuanced decision that can be particularly challenging when an ICU attending first takes over a patient’s care during a care transition (Figure 1). Extubating too early has clear consequences, but waiting too long also has risks, including ventilator-associated pneumonia. In a study across three medical ICUs within a single urban health system and 3600 ICU-days, researchers evaluated the rate of ventilator liberation on days when a new attending came on service (transition days) compared with days when attending coverage remained constant.