Prevention of unplanned endotracheal extubation in intensive care unit: An overview of systematic reviews

Abstract

Aims This study was performed to identify and summarize systematic reviews focusing on the prevention of unplanned endotracheal extubation in the intensive care unit. Design Overview of systematic reviews. Methods This overview was conducted according to the Preferred Reporting Items for Overviews of Systematic Reviews, including the harms checklist. A literature search of PubMed, the Cochrane Library, CINAH, Embase, Web of Science, SINOMED and PROSPERO was performed from January 1, 2005–June 1, 2021. A systematic review focusing on unplanned extubation was included, resulting in an evidence summary. Results Thirteen systematic reviews were included. A summary of evidence on unplanned endotracheal extubation was developed, and the main contents were risk factors, preventive measures and prognosis. The most important nursing measures were restraint, fixation of the tracheal tube, continuous quality improvement, psychological care and use of a root cause analysis for the occurrence of unplanned endotracheal extubation. Conclusions This overview re‐evaluated risk factors and preventive measures for unplanned endotracheal extubation in the intensive care unit, resulting in a summary of evidence for preventing unplanned endotracheal extubation and providing direction for future research. Trial registration details The study was registered on the PROSPERO website.

Impact of two endotracheal tube fixation on the incidence of peri-oral lesions: Elastic adhesive strips versus cord in a protective sheath. Study protocol for a cluster cross-over randomized trial

“…However, securing the ETT with a suitable fixation system to prevent unplanned extubation is a matter that needs to be addressed. In their recent review, Wu and al [15] recommend carrying out more randomized controlled trials related to ETT fixation. The present study could provide data to make progress on that topic An independent safety committee (ISC) board has been constituted after the start of the study.…”

“…Nevertheless, fixation systems developed by the pharmaceutical industry exert more pressure on the facial skin as suggested by a mannequin study comparing 10 sophisticated industrial systems and 6 "simple" systems [ 10 ]. Regarding preventive measures for the prevention of unplanned endotracheal extubation in the ICU, a recent review concluded that an optimal method of endotracheal tube fixation has not been established [ 15 ].…”

Development and testing of a questionnaire assessing knowledge, attitudes, and practices to prevent unplanned oral extubation

“…Based on literature search for risk factors, preventive strategies, and KAP, 13–24 as well as the theoretical framework of KAP, 25,26 a total of 91 initial items were prepared as a part of the primary questionnaire. In the knowledge section, there was only one correct answer for each item, and each correct answer was given 1 point.…”

“…Based on literature search for risk factors, preventive strategies, and KAP, [13][14][15][16][17][18][19][20][21][22][23][24] as well as the theoretical framework of KAP, 25,26 a total of 91 initial items were prepared as a part of the primary questionnaire.…”

“…The KAP questionnaire is a proven scientific, objective, and reliable tool. Some scholars have designed a KAP questionnaire on UEE, 13 with a focus on the factors of TEI itself but without highlighting the preventive measures for UEE. Thus, a reliable and valid instrument that fully measures KAP on UEE should be established to provide vital information for deciding the best intervention programs and help reduce the rates of UEE.…”