Self-Extubation Rate and Sedation Requirement in Covid-19

Abstract

After the novel coronavirus disease (COVID-19), was declared a pandemic, New York quickly became the new epicenter of the disease. This study was conducted during the peak of COVID-19 in Queens. Many COVID-19 patients with severe acute respiratory distress syndrome (ARDS) required endotracheal intubation and heavy sedation for prolonged periods of time. Unplanned extubation (UE) events have a notable impact on clinical course and outcome. [1] Self-extubation (SE) is the most common reason for UE, and inadequate sedation is one of its most significant risk factors. [1,2] This study examines factors associated with SE events in patients with ARDS in COVID-19. METHODS: At a single acute tertiary care hospital located in Queens, New York, all patients with SARS-CoV-2 infection admitted between March 15, 2020 and April 15, 2020, were screened. Active COVID-19 status was confirmed with reverse transcriptase-polymerase chain reaction assay performed on nasopharyngeal samples. All patients who underwent endotracheal intubation were included in the study. All data were collected from the electronic health record for 28-day outcomes. All UE events, including SE and other causes for UE, number and dosages of sedatives at the time of SE, adverse events, such as cardiac arrest and anoxic brain injury following UE, were examined.