Intensive Care Medicine

, Volume 19, Issue 6, pp 340–342

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

  • T. Vassal
  • N. G. D. Anh
  • J. M. Gabillet
  • B. Guidet
  • F. Staikowsky
  • G. Offenstadt
Brief Reports

DOI: 10.1007/BF01694708

Cite this article as:
Vassal, T., Anh, N.G.D., Gabillet, J.M. et al. Intensive Care Med (1993) 19: 340. doi:10.1007/BF01694708

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.

Key words

Self-extubation Deliberate self-extubation Accidental self-extubation Oral intubation Nasal intubation Reintubation Agitation Sedation Respiratory distress 

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • T. Vassal
    • 1
  • N. G. D. Anh
    • 1
  • J. M. Gabillet
    • 1
  • B. Guidet
    • 1
  • F. Staikowsky
    • 1
  • G. Offenstadt
    • 1
  1. 1.Service de Réanimation PolyvalenteHôpital Saint-AntoineParisFrance

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