Extubation in intensive care units in the UK: an online survey

To determine the current practice among critical care nurses in the UK with regard to airway management during cuff deflation and extubation.

There are a number of techniques used by clinicians to prevent aspiration during cuff deflation and extubation of patients. There are no published clinical studies comparing the different manoeuvres available to clinicians at the time of extubation nor any data to suggest which technique is most commonly used.

All members of the British Association of Critical Care Nurses with an email address were invited to participate in an online survey.

A total of 533 (29%) nurses from 184 (84%) intensive care unit (ICUs) in the UK completed the survey. Just under half of the sample (n = 258, 48.4%) had more than 10 years of critical care experience and the vast majority (n = 427, 80.1%) worked in general ICUs. The majority of respondents (n = 461, 86.5%) suction the trachea during cuff deflation and extubation. A further 304 (57%) respondents ask patients to cough as part of extubation. Respondents increase the positive end expiratory pressure setting on the ventilator infrequently as part of routine procedure for extubation (n = 7, 1.3%).

The majority of UK critical care nurses either suction the trachea during cuff deflation and extubation of patients and/or simply ask the patient to cough. Further clinical trials are required to identify the most appropriate and safe technique for critically ill patients.