Transitions in intensive care: Investigating critical slowing down post extubation

Abstract

Complex biological systems undergo sudden transitions in their state, which are often preceded by a critical slowing down of dynamics. This results in longer recovery times as systems approach transitions, quantified as an increase in measures such as the autocorrelation and variance. In this study, we analysed paediatric patients in intensive care for whom mechanical ventilation was discontinued through removal of the endotracheal tube (extubation). Some patients failed extubation, and required a re-intubation within 48 hours. We investigated whether critical slowing down could be observed post failed extubations, prior to re-intubation. We tested for significant increases (p