Prospective evaluation of self-extubations in a medical intensive care unit
- 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
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To evaluate the incidence, associated factors and gravity of self-extubations.
Prospective study about all patients intubated over an 8 month period.
A medical intensive care unit of a University Hospital.
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.
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.
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.