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Self-extubations. A 12-month experience.

D P Coppolo1, J J May

  • 1Mary Imogene Bassett Hospital, Cooperstown, NY 13326.

Chest
|July 1, 1990
PubMed
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Self-extubation (SXT), or unplanned removal of endotracheal tubes, occurred in 11% of adult ICU patients. Despite risks, most cases were deliberate and tolerated well, with no resulting deaths.

Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Patient Safety

Background:

  • Unplanned endotracheal tube removal (self-extubation, SXT) is a critical event in intensive care units (ICUs).
  • Understanding the incidence and risk factors for SXT is crucial for patient safety.

Purpose of the Study:

  • To determine the incidence of self-extubation in adult ICU patients.
  • To identify potential risk factors associated with self-extubation.
  • To evaluate the outcomes and complications following self-extubation.

Main Methods:

  • Prospective monitoring of all intubated adult ICU patients over one year.
  • Comparison of patients who self-extubated (SXT group) with those who did not (NXT group).
  • Analysis of patient demographics, tube characteristics, ventilation settings, and sedation use.

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Main Results:

  • The overall incidence of self-extubation was 11% (12 out of 112 patients).
  • No significant risk factors were identified when comparing SXT and NXT groups.
  • Sixty-nine percent of SXT events were deliberate, often occurring despite sedation and restraints.
  • The complication and reintubation rate in the SXT group was 31%, with 11% for deliberate extubations.
  • No deaths were reported secondary to self-extubation.

Conclusions:

  • Self-extubation is a common occurrence in adult ICUs.
  • Deliberate self-extubation is frequent and often happens despite interventions.
  • While associated with complications, self-extubation in adults may be tolerated without mortality.