Introduction/objectiveExtubation failure increases morbidity and mortality in pediatric cardiac patients, a unique population including those with congenital heart disease or acquired heart disease. This study aimed to evaluate the predictive factors of extubation failure in pediatric cardiac patients and to determine the association between extubation failure and clinical outcomes.MethodsWe conducted a retrospective study in the pediatric cardiac intensive care unit (PCICU) of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, from July 2016 to June 2021. Extubation failure was defined as the re-insertion of the endotracheal tube within 48 hours after extubation. Multivariable log-binomial regression with generalized estimating equations (GEE) was performed to explore the predictive factors associated with extubation failure.ResultsWe collected 318 extubation events from 246 patients. Of these, 35 (11%) events were extubation failures. In physiologic cyanosis, the extubation failure group had significantly higher SpO2 than the extubation success group (P < 0.001). The predictive factors associated with extubation failure included a history of pneumonia before extubation (RR 3.09, 95% CI 1.54–6.23, P = 0.002), stridor after extubation (RR 2.57, 95% CI 1.44–4.56, P = 0.001), history of re-intubation (RR 2.24, 95% CI 1.21–4.12, P = 0.009), and palliative surgery (RR 1.87, 95% CI 1.02–3.43, P = 0.043).ConclusionExtubation failure was identified in 11% of extubation attempts in pediatric cardiac patients. The extubation failure was associated with a longer duration of PCICU stay but not with mortality. Patients with a history of pneumonia before extubation, history of re-intubation, post-operative palliative surgery, and post-extubation stridor should receive careful consideration before extubation and close monitoring afterward. Additionally, patients with physiologic cyanosis may require balanced circulation via regulated SpO2.

Objectives To study differences in knowledge, risky behavior and attitudes related to sexually transmitted diseases in male undergraduate students from three faculties of Chiang Mai University. Methods This cross-sectional study surveyed 652 male undergraduate students from three faculties including 85 from Associated Medical Science (AMS), 480 from Engineering (ENG) and 87 from Economics (ECON) as representative of health sciences, science/technology, and social sciences/humanities, respectively. An online questionnaire was used to evaluate the students’ knowledge, risky behavior and attitudes related to sexually transmitted diseases (STDs). Descriptive statistics included one-way ANOVA and Spearman’s rank correlation coefficient. Results AMS male students had a higher average score for knowledge related to STDS than the other groups. There were, however, significant differences among AMS students to the questions, “Should parents teach appropriate sex education to their young children?” and “Do you think early STD screening is good?” (both p = 0.001). Positive correlations were found between self-reported alcohol drinking and visiting of entertainment places in all the groups (rAMS = 0.673, p < 0.001; rENG = 0.595, p < 0.001; rECON= 0.595, p < 0.001). Self-reported risky behavior was positively correlated with frequency of having sex during the past 2 months and alcoholic drinking (rAMS = 0.510 and = 0.409; rENG = 0.562 and = 0.345; rECON = 0.655 and = 0.259, respectively. All were p < 0.001) Conclusions Male health sciences students possessed higher knowledge, reported lower risk behaviors, and expressed more positive attitudes toward individuals with STDs than the other groups. Providing knowledge about STDs and encouraging abstinence from alcohol should be used to reduce the incidence of risky behavior and the incidence of STDs among male university undergraduates.