A prospective study of unplanned endotracheal extubation in intensive care unit patients
- 1 July 1998
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 26 (7), 1180-1186
- https://doi.org/10.1097/00003246-199807000-00016
Abstract
To evaluate incidence, factors associated with unplanned endotracheal extubation (UEE), and prognostic factors for reintubation. A prospective study over a 32-mo period. A 16-bed general intensive care unit of a tertiary university hospital. Adult subjects undergoing endotracheal intubation for >48 hrs. Observation of patients who presented unplanned extubation. Over the 32-mo period, there were 59 episodes of UEE in 55 patients (frequency 7.3%). Deliberate self-extubation occurred in 46 episodes (77.9%), while there were 13 episodes (22.1%) of accidental extubation. Twenty-seven (45.8%) episodes occurred in patients who were receiving full mechanical ventilatory support and 32 (54.2%) eplsodes occurred during the weaning period from mechanical ventilation. Reintubation was required in 27 (45.8%) episodes of UEE. The need for reintubation after UEE was 36.9% in deliberate self-extubation patients and 76.9% in accidental extubation patients (p = .01). Only 15.6% (5/32) of patients who presented UEE during weaning required reintubation, while reintubation was mandatory in 81.5% (22/27) of patients who presented UEE during full mechanical ventilatory support (p Reintubation in UEE patients strongly depends on the type of mechanical ventilatory support. The probability of requiring reintubation if UEE occurs during full ventilatory support is higher than if UEE occurs during weaning. These data suggest that some patients are under mechanical ventilation longer than necessary. (Crit Care Med 1998; 26:1180-1186)Keywords
This publication has 17 references indexed in Scilit:
- Effect on the Duration of Mechanical Ventilation of Identifying Patients Capable of Breathing SpontaneouslyNew England Journal of Medicine, 1996
- Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation.American Journal of Respiratory and Critical Care Medicine, 1994
- Prospective evaluation of self-extubations in a medical intensive care unitIntensive Care Medicine, 1993
- Incidence, Risk, and Prognosis Factors of Nosocomial Pneumonia in Mechanically Ventilated PatientsAmerican Review of Respiratory Disease, 1990
- Self-ExtubationsChest, 1990
- APACHE IICritical Care Medicine, 1985
- Complications and consequences of endotracheal intubation and tracheotomyAmerican Journal Of Medicine, 1981
- Basic principles of ROC analysisSeminars in Nuclear Medicine, 1978
- Complications of assisted ventilationAmerican Journal Of Medicine, 1974
- Controlled Sedation with Alphaxalone-AlphadoloneBMJ, 1974