Literature DB >> 8227724

Prospective evaluation of self-extubations in a medical intensive care unit.

T Vassal1, N G Anh, J M Gabillet, B Guidet, F Staikowsky, G Offenstadt.   

Abstract

OBJECTIVE: To evaluate the incidence, associated factors and gravity of self-extubations.
DESIGN: Prospective study about all patients intubated over an 8 month period.
SETTING: A medical intensive care unit of a University Hospital. PATIENTS: Patients were divided into two groups: self-extubated and those that did not. The self-extubations were separated into deliberate acts by the patients and accidental.
RESULTS: 24 of the 197 patients included presented a total of 27 extubations (12%). There were 21 deliberate incidents and 6 accidental. The only differences between the cases and the rest of the population were a higher mean age (67 vs 59 years) and a larger proportion of chronic respiratory failure (66% versus 35%). Reintubation was necessary in 20 cases (74%) within 30 min in 16 cases. The main indication for reintubation was acute respiratory distress (90%). Reintubation was associated with one death.
CONCLUSION: Self-extubation is a frequent and serious complication of mechanical ventilation. Deliberate self-extubation, the most frequent type of incident could possibly be reduced by better sedation of agitated patients and accidental self-extubation by better training of the nursing staff.

Entities:  

Mesh:

Year:  1993        PMID: 8227724     DOI: 10.1007/bf01694708

Source DB:  PubMed          Journal:  Intensive Care Med        ISSN: 0342-4642            Impact factor:   17.440


  11 in total

1.  Self-extubation.

Authors:  R D Brandstetter; I T Khawaja; E Bartky
Journal:  Chest       Date:  1991-05       Impact factor: 9.410

2.  Alteration of endotracheal tube position. Flexion and extension of the neck.

Authors:  P A Conrardy; L R Goodman; F Lainge; M M Singer
Journal:  Crit Care Med       Date:  1976 Jan-Feb       Impact factor: 7.598

Review 3.  The complications of tracheal intubation: a new classification with a review of the literature.

Authors:  V F Blanc; N A Tremblay
Journal:  Anesth Analg       Date:  1974 Mar-Apr       Impact factor: 5.108

4.  Complications of assisted ventilation. A prospective study of 354 consecutive episodes.

Authors:  C W Zwillich; D J Pierson; C E Creagh; F D Sutton; E Schatz; T L Petty
Journal:  Am J Med       Date:  1974-08       Impact factor: 4.965

5.  Determinants of weaning and survival among patients with COPD who require mechanical ventilation for acute respiratory failure.

Authors:  R Menzies; W Gibbons; P Goldberg
Journal:  Chest       Date:  1989-02       Impact factor: 9.410

6.  Problems with prolonged endotracheal intubations.

Authors:  M N Dubick
Journal:  Chest       Date:  1978-10       Impact factor: 9.410

7.  Prevention of complications from prolonged tracheal intubation.

Authors:  F R Lewis; R M Schiobohm; A N Thomas
Journal:  Am J Surg       Date:  1978-03       Impact factor: 2.565

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Authors:  W M Keane; J C Denneny; L D Rowe; J P Atkins
Journal:  Ann Otol Rhinol Laryngol       Date:  1982 Nov-Dec       Impact factor: 1.547

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Authors:  J L Stauffer; D E Olson; T L Petty
Journal:  Am J Med       Date:  1981-01       Impact factor: 4.965

10.  Self-extubations. A 12-month experience.

Authors:  D P Coppolo; J J May
Journal:  Chest       Date:  1990-07       Impact factor: 9.410

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  11 in total

1.  Prospectively defined indicators to improve the safety and quality of care for critically ill patients: a report from the Task Force on Safety and Quality of the European Society of Intensive Care Medicine (ESICM).

Authors:  A Rhodes; R P Moreno; E Azoulay; M Capuzzo; J D Chiche; J Eddleston; R Endacott; P Ferdinande; H Flaatten; B Guidet; R Kuhlen; C León-Gil; M C Martin Delgado; P G Metnitz; M Soares; C L Sprung; J F Timsit; A Valentin
Journal:  Intensive Care Med       Date:  2012-01-26       Impact factor: 17.440

2.  Effectiveness of a continuous quality improvement program aiming to reduce unplanned extubation: a prospective study.

Authors:  A A Chiang; K C Lee; J C Lee; C H Wei
Journal:  Intensive Care Med       Date:  1996-11       Impact factor: 17.440

3.  Severe agitation among ventilated medical intensive care unit patients: frequency, characteristics and outcomes.

Authors:  Jeffery C Woods; Lorraine C Mion; Jason T Connor; Florence Viray; Lisa Jahan; Cecilia Huber; Renee McHugh; Jeffrey P Gonzales; James K Stoller; Alejandro C Arroliga
Journal:  Intensive Care Med       Date:  2004-02-14       Impact factor: 17.440

4.  Development of a risk assessment tool for deliberate self-extubation in intensive care patients.

Authors:  Philip Moons; Kristine Sels; Wilfried De Becker; Sabina De Geest; Patrick Ferdinande
Journal:  Intensive Care Med       Date:  2004-03-25       Impact factor: 17.440

5.  Risk factors and outcomes after unplanned extubations on the ICU: a case-control study.

Authors:  Robin I de Groot; Olaf M Dekkers; Ingeborg Hf Herold; Evert de Jonge; M Sesmu Arbous
Journal:  Crit Care       Date:  2011-01-13       Impact factor: 9.097

6.  Overview of medical errors and adverse events.

Authors:  Maité Garrouste-Orgeas; François Philippart; Cédric Bruel; Adeline Max; Nicolas Lau; B Misset
Journal:  Ann Intensive Care       Date:  2012-02-16       Impact factor: 6.925

7.  A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit.

Authors:  Preet Mohinder Singh; Vimi Rewari; Mahesh Kumar Arora; Anjan Trikha
Journal:  J Emerg Trauma Shock       Date:  2013-10

8.  Prognostic factors and outcomes of unplanned extubation.

Authors:  Chien-Ming Chao; Mei-I Sung; Kuo-Chen Cheng; Chih-Cheng Lai; Khee-Siang Chan; Ai-Chin Cheng; Shu-Chen Hsing; Chin-Ming Chen
Journal:  Sci Rep       Date:  2017-08-17       Impact factor: 4.379

9.  Accidental catheter removal in critically ill patients: a prospective and observational study.

Authors:  Leonardo Lorente; María S Huidobro; María M Martín; Alejandro Jiménez; María L Mora
Journal:  Crit Care       Date:  2004-06-02       Impact factor: 9.097

10.  Unplanned Extubation in Patients with Mechanical Ventilation: Experience in the Medical Intensive Care Unit of a Single Tertiary Hospital.

Authors:  Tae Won Lee; Jeong Woo Hong; Jung-Wan Yoo; Sunmi Ju; Seung Hun Lee; Seung Jun Lee; Yu Ji Cho; Yi Yeong Jeong; Jong Deog Lee; Ho Cheol Kim
Journal:  Tuberc Respir Dis (Seoul)       Date:  2015-10-01
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