Journal of Medical and Surgical Intensive Care Medicine 2017 , Vol 8, Issue 1
Risk Factors for Reintubation and Effects of Reintubation on Outcomes of Intensive Care Patients with Unplanned Extubation
Özlem Ediboğlu 1 , Pınar Çimen 1 , Ceyda Anar 1 , Cenk Kıraklı 1 , Dursun Tatar 1
1Dr. Suat Seren Göğüs Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Yoğun Bakım Bölümü, İzmir, Türkiye DOI : 10.5152/dcbybd.2017.1436

Objective: When unplanned extubation (UE) occurs in intensive care patients, mechanical ventilation is negatively affected. In this study, we aimed to investigate the characteristics of UE patients, the duration of extubation, and the characteristics of reintubated patients.

Material and Methods: In this retrospective cohort study of UE patients between May 1, 2010 and December 31, 2012, reintubated patients were included in Group 1 (n=12) and patients who did not require reintubation were included in Group 2 (n=12). The demographic features, mechanical ventilation mode, UE cause (patient/staff), APACHE II score, presence of ventilator-associated pneumonia, extubation time, sedation requirement,  NIV requirement after extubation, and need of reintubation  were recorded. Patients in groups 1 and 2 were compared in terms of risk factors for reintubation.

Results: Twenty-four patients (23 males) were included. Their median age was 75 years (range, 56-81 years) Group 1=79 years (range, 74-81 years) and Group 2=62 years (range, 56-76 years). The APACHE II score was significantly higher in Group 1 patients than in Group 2 patients (27 vs. 23, p=0.03). The pH was significantly lower  in Group 1 (7.26 vs. 7.35, p=0.008). Weaning was significantly lower and mortality was significantly higher in Group 1 patients than in Group 2 patients (1/12 vs. 8/12, p=0.003 and 11/12 vs. 1/12, p=0.0001, respectively). The number of patients with ventilator-associated pneumonia was higher in Group 1 than in Group 2 (7/12 vs 2/12, p = 0.035). NIV was applied to all patients except one.

Conclusion: Unplanned extubation is an undesirable condition in intensive care. Patients with advanced age and high APACHE II scores may be at a high risk of reintubation and mortality.

Cite this article as: Ediboğlu Ö, Çimen P, Anar C, et al. Risk Factors for Reintubation and Effects of Reintubation on Outcomes of Intensive Care Patients with Unplanned Extubation. Yoğun Bakım Derg 2017; 8: 10-3.

Keywords : Intubation, pneumonia, mortality, intensive care