Unplanned Extubations in Intensive Care Unit: evidences for risk factors. A literature review

Unplanned Extubations in Intensive Care Unit: evidences for risk factors. A literature review

Authors

  • Chiara Cosentino Department of Medicine and Surgery, University of Parma http://orcid.org/0000-0003-1324-4007
  • Mattia Fama Neonatology and Neonatal Intensive Care Unit, Filippo del Ponte Hospital, Varese, Italy
  • Chiara Foà Department of Medicine and Surgery, University of Parma
  • Giorgia Bromuri High Intensity Care, Cardiothoracis Vascular Unit, Polyclinic S.Orsola Malpighi, Bologna
  • Serena Giannini Emergency Room, Infermi Hospital, Rimini
  • Marco Saraceno General Medicine Unit, Ponte San Pietro Clinic, Bergamo
  • Angela Spagnoletta Cardiology & Cardiological Itensive Care Unit, Local Health and Social Care Centre Pavia, Pavia
  • Mbemo Tenkue Freelance Nurse
  • Elena Trevisi Cardiology & Cardiological Itensive Care Unit, Local Health and Social Care Centre Piacenza, Piacenza
  • Leopoldo Sarli Department of Medicine and Surgery, University of Parma

Keywords:

Unplanned extubation, risk factors, nurse, intensive care unit, night shift

Abstract

Background and aim: Unplanned extubations (UE) are getting more and more relevant in Critical Care, becoming a quality and care safeness outcome. This happens because after an UE the patient can face some complications concerning the airway management, respiratory and hemodynamic problems, lengthen in the hospital stay and in the mechanical ventilation time.  The aim of this review is identify and classify the factors that could increase UE risk. Methodology: A systematic review of scientific articles was performed consulting the databases PubMed, Cinahl, Medline, EBSCOhost and Google Scholar. Articles from 2006 to 2011 were included. Pediatric Care settings were excluded. Results: 21 articles were selected. From the results emerged that risk factors associated to the patient are widely controversial. Yet restlessness, a low level of sedation and a high level of consciousness seem to be highly related to UE. Organizational risk factors, as workload, nurse:patient ratio, and the use of interdisciplinary protocols seem to play an important role in UE. Conclusion: According the current literature, the research on UE still has to handle a wide uncertainty. There is the need for more studies developing conclusive evidences on the role of different risk factors. Anyway, literature highlights the importance of the nurse and of the healthcare system organization in reducing UE incidence.

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Published

30-11-2017

Issue

Section

Original article: Evidences in Intensive Care Units

How to Cite

1.
Unplanned Extubations in Intensive Care Unit: evidences for risk factors. A literature review. Acta Biomed [Internet]. 2017 Nov. 30 [cited 2024 Jun. 24];88(5-S):55-6. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/6869