Unplanned extubation in critically ill adults: clinical review

Abstract

Identifying risk factors for UE and minimizing UE incidence through appropriate preventive strategies are prerequisites for improving nursing care quality and patient safety in the ICU.

Ventilator-Related Adverse Events: A Taxonomy and Findings From 3 Incident Reporting Systems

“…Moreover, they can contribute to agitation, 10 and are discouraged unless necessary due to other safety concerns. 22,23 However, unplanned extubations generally are not related to the functioning of the ventilator itself. The key contribution of the ventilator is to alert caregivers to the airway disconnection.…”

Self-extubation in ICU patients

“…Therefore, in the majority of patients who do not require re-intubation, self-extubation can actually decrease the length of intubation and weaning. 2,3,9 The complications of self-extubation are seen most often in patients requiring re-intubation, which occurs within an hour of self-extubation in 85%-90% of cases.…”

Reducing Unplanned Extubations in the Pediatric ICU: Are We Seeing the Whole Picture?

“…In fact, self-extubation is defined, in the available literature, as either deliberate or purposeful removal of the endotracheal tube by the patient her/himself. 2 In contrast, accidental extubation is attributed to personnel's inappropriate manipulation of the tube during patient care or to a non-purposeful patient action. 2 This distinction is of the utmost importance, since the types of unplanned extubations may differ significantly in terms of incidence, risk factors, and effects on patient outcomes.…”

“…2 In contrast, accidental extubation is attributed to personnel's inappropriate manipulation of the tube during patient care or to a non-purposeful patient action. 2 This distinction is of the utmost importance, since the types of unplanned extubations may differ significantly in terms of incidence, risk factors, and effects on patient outcomes. 2 Given that neurocognitive development differs among children and is different throughout childhood, pediatric studies have not adopted the self-extubation definition when treating their data.…”

“…2 This distinction is of the utmost importance, since the types of unplanned extubations may differ significantly in terms of incidence, risk factors, and effects on patient outcomes. 2 Given that neurocognitive development differs among children and is different throughout childhood, pediatric studies have not adopted the self-extubation definition when treating their data. Hence, for the sake of external validation, a more appropriate definition of pediatric unplanned extubation should have been used.…”