Unplanned Extubation in Patients with Mechanical Ventilation: Experience in the Medical Intensive Care Unit of a Single Tertiary Hospital.
BACKGROUND
Potentially harmful unplanned extubation (UE) may occur in patients on mechanical ventilation (MV) in an intensive care unit (ICU) setting. This study aimed to evaluate the clinical characteristics of UE and its impact on clinical outcomes in patients with MV in a medical ICU (MICU).


METHODS
We retrospectively evaluated MICU data prospectively collected between December 2011 and May 2014.


RESULTS
A total of 468 patients were admitted to the MICU, of whom 450 were on MV. Of the patients on MV, 30 (6.7%) experienced UE; 13 (43.3%) required reintubation after UE, whereas 17 (56.7%) did not require reintubation. Patients who required reintubation had a significantly longer MV duration and ICU stay than did those not requiring reintubation (19.4±15.1 days vs. 5.9±5.9 days days and 18.1±14.2 days vs. 7.1±6.5 days, respectively; p<0.05). In addition, mortality rate was significantly higher among patients requiring reintubation than among those not requiring reintubation (54.5% vs. 5.9%; p=0.007). These two groups of patients exhibited no significant differences, within 2 hours after UE, in the fraction of inspired oxygen, blood pressure, heart rate, respiratory rate, and pH.


CONCLUSIONS
Although reintubation may not always be required in patients with UE, it is associated with a poor outcome after UE.
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Tae Won
TW
Lee
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Jeong Woo
JW
Hong
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Jung-Wan
JW
Yoo
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Sunmi
S
Ju
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Seung Hun
SH
Lee
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Seung Jun
SJ
Lee
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Yu Ji
YJ
Cho
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Yi Yeong
YY
Jeong
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Jong Deog
JD
Lee
Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Ho Cheol
HC
Kim
Airway Extubation; Intensive Care Units; Respiration, Artificial