Extubation Advisor (EA)

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OBS Medical and Therapeutic Monitoring Systems (TMS) have partnered to provide a suite of complimentary AI driven technologies to enhance patient care. Extubation Advisor (EA) is the first of such technologies available to market within the European Economic Area (EEA) and UK.

Extubation Advisor (EA) is the first clinical decision support tool developed to provide prediction of extubation outcomes and standardize the assessment of extubation readiness. EA combines a respiratory rate variability (RRV) derived predictive model of the risk of extubation failure called the WAVE score, the rapid shallow breathing index (RSBI), clinical impression of extubation failure risk, and a standardized extubation readiness checklist to generate an extubation report for clinical decision-making [5].

This combination of standardized SBT performance and reporting, along with optimal prediction of extubation outcomes aims to minimise extubation failure and enhance care [4]. The report generated by Extubation Advisor is used to drive clinical management when determining the best course of action for each patient being evaluated for extubation. Extubation Advisor can be run multiple times, providing updated SBT performance, prediction of extubation failure reports, means to mitigate extubation failure risk and clinical assessment, to be used when considering extubation.

Expeditious, safe extubation is vitally important in the care of Intensive Care Unit (ICU) patients as prolonged mechanical ventilation harms patients, and failed extubation (i.e. re-intubation within 48hrs) is associated with increased morbidity, mortality and costs [1-3].

  • Standardized assessment of extubation readiness
  • Enhanced prediction of extubation outcomes
  • Individualized risk mitigation strategies
  • Documentation of SBT performance
  • Less unnecessary, harmful, prolonged mechanical ventilation
  • Lower rate of re-intubation after extubation
  • Streamlined extubation decision process
  • Cost effective if reduction in extubation failure >0.6%.


  1. Epstein SK, Ciubotaru RL, Wong JB. Effect of failed extubation on the outcome of mechanical ventilation. Chest. 1997 Jul;112(1):186-92. doi: 10.1378/chest.112.1.186. PMID: 9228375.
  2. Menon N et al.: Occurrence and complications of tracheal reintubation in critically ill adults. Respiratory Care 2012;57(10):1555-1563.
  3. Seymour CW et al.: The outcome of extubation failure in a community hospital intensive care unit: a cohort study. Critical Care 2004;8(5)R322-R327.
  4. Stephanie Godard, Christophe Herry, Paul Westergaard, et al., “Practice Variation in Spontaneous Breathing Trial Performance and Reporting,” Canadian Respiratory Journal, vol. 2016, Article ID 9848942, 10 pages, 2016.
  5. Seely et al.: Do heart and respiratory rate variability improve prediction of extubation outcomes in critically ill patients? Critical Care 2014 18:R65.
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