Prospective evaluation of self-extubations in a medical intensive care unit.
OBJECTIVE
To evaluate the incidence, associated factors and gravity of self-extubations.


METHODS
Prospective study about all patients intubated over an 8 month period.


METHODS
A medical intensive care unit of a University Hospital.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Vassal
T
T
Service de Réanimation Polyvalente, Hôpital Saint-Antoine, Paris, France.
Anh
N G
NG
Gabillet
J M
JM
Guidet
B
B
Staikowsky
F
F
Offenstadt
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000451:nursing / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data