Unplanned extubations in general intensive care unit: A nine-year retrospective analysis

Unplanned extubations in general intensive care unit: A nine-year retrospective analysis

Authors

  • Alberto Lucchini ASST Monza, Ospedale San Gerardo - università degli Studi di Milano-Bicocca https://orcid.org/0000-0002-7475-277X
  • Stefano Bambi 2. Medical & Surgical Intensive Care Unit, Careggi University Hospital, Florence (Italy)
  • Alessandro Galazzi 3. Intensive Care Units Area, IRCCS Ca’ Granda Foundation, Maggiore University Hospital, Milan (Italy)
  • Stefano Elli 1. General Intensive Care Unit, San Gerardo Hospital, Monza. Milano-Bicocca University, Milan (Italy)
  • Cristina Negrini Mamma e Bambino Foundation, Monza e Brianza (Italy)
  • Stefania Vaccino Intensive Care Unit, Vigevano Hospital, Pavia (Italy)
  • Silvia Triantafillidis Anesthesia and Intensive Care Unit 2nd, Bolzano Hospital (Italy)
  • Alessandra Biancardi
  • Mattia Cozzari General Intensive Care Unit, Modena University Hospital, Modena (Italy)
  • Roberto Fumagalli 9. General Intensive Care Unit, Niguarda Hospital, Milan. Milano-Bicocca University, Milan (Italy)
  • Giuseppe Foti General Intensive Care Unit, Niguarda Hospital, Milan. Milano-Bicocca University, Milan (Italy)

Keywords:

unplanned extubation, self extubation, accidental extubation, adverse events

Abstract

Background and aim: Unplanned extubation (UE) in Intensive Care Units (ICU) is an indicator of quality and safety of care. UEs are classified in: accidental extubations, if involuntarily caused during nursing care or medical procedures; self-extubation, if determined by the patient him/herself.  In scientific literature, the cumulative incidence of UEs varies from 0.3% to 35.8%. The aim of this study is to explore the incidence of UEs in an Italian university general ICU adopting a well-established protocol of tracheal tube nursing management and fixation. Methods: retrospective observational study. We enrolled all patients undergone to invasive mechanical ventilation from 1st January 2008 to 31st December 2016. Results: in the studied period 3422 patients underwent to endotracheal intubation. The UEs were 35: 33 self extubations (94%) and 2 accidental extubations (6%). The incidence of UEs calculated on 1497 patients intubated for more than 24 hours was 2.34%. Instead, it was 1.02%, if we consider the whole number of intubated patients. Only in 9 (26%) cases out of 35 UEs the patient was re-intubated. No deaths consequent to UE were recorded. Conclusions: The incidence of UEs in this study showed rates according to the minimal values reported in scientific literature. A standardized program of endotracheal tube management (based on an effective and comfortable fixing system) seems to be a safe and a valid foundation in order to maintain the UE episodes at minimum rates.

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Published

07-12-2018

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Section

Original article: Technical skills and tools

How to Cite

1.
Unplanned extubations in general intensive care unit: A nine-year retrospective analysis. Acta Biomed [Internet]. 2018 Dec. 7 [cited 2024 Jun. 19];89(7-S):25-31. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/7815

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