Maximum Expiratory Pressure in Induced Cough as a Predictor of Extubation Failure

Inclusion Criteria: * Under mechanical ventilation via endotracheal tube in a period greater than 48 hours * Passing the spontaneous breathing trial an be ready for extubation. * Agree to participate in the study and sign the informed consent by the patient or family member Exclusion Criteria: * tracheostomized prior to admission to mechanical ventilation * history of neuromuscular disease * presence of unstable heart disease * received upper digestive surgery * presence of uncontained enterocutaneous fistula * candidates for non-invasive ventilation as a modality of interface exchange for extubation or as a preventive modality * patients who did not reach a MEP (habitual) of 30 cmH20 since they are not extubated by the extubation protocol of our institution.