Inclusion Criteria:  Oro-tracheal intubation Mechanical ventilation for more than 24 h Extubation decision made by physician in charge (weaning criteria ok + weaning test succeeded) First extubation procedure within the stay in the inclusion unit Non-objection collected from the patient or a relative of the patient Affiliated to an heath care insurance  Exclusion Criteria:  Pregnant woman Tracheostomy Neuro-muscular pre-existant disease or severe head injury Limitation of active therapeutics Objection to the study expressed by the patient Inclusion in an other research interfering with our outcomes