Unplanned endotracheal extubations in the intensive care unit: Systematic review, critical appraisal, and evidence-based recommendations

Anesthesia and Analgesia

Volumn 114, Issue 5, 2012, Pages 1003-1014

  Da Silva, Paulo Sergio Lucas ^a   Fonseca, Marcelo Cunio MacHado ^b  

^a HOSPITAL DO SERVIDOR PÚBLICO ESTADUAL DE SÃO PAULO   (Brazil)

^b FEDERAL UNIVERSITY OF SÃO PAULO   (Brazil)

Author keywords

[No Author keywords available]

Indexed keywords

AGITATION; CHRONIC OBSTRUCTIVE LUNG DISEASE; CONSCIOUSNESS LEVEL; ENDOTRACHEAL INTUBATION; EVIDENCE BASED MEDICINE; EXTUBATION; GENDER; HUMAN; INTENSIVE CARE; PRIORITY JOURNAL; PUBLICATION; RESTLESSNESS; REVIEW; RISK FACTOR; SEDATION; SYSTEMATIC REVIEW;

AIRWAY EXTUBATION; ANALGESIA; BENCHMARKING; CASE-CONTROL STUDIES; COHORT STUDIES; CONSCIOUS SEDATION; EVIDENCE-BASED MEDICINE; FEMALE; HUMANS; INTENSIVE CARE UNITS; INTUBATION, INTRATRACHEAL; MALE; NURSES; RESPIRATION, ARTIFICIAL; RESTRAINT, PHYSICAL; RISK FACTORS; SEX FACTORS; TREATMENT OUTCOME; VENTILATOR WEANING;

EID: 84860295624     PISSN: 00032999     EISSN: None     Source Type: Journal    
DOI: 10.1213/ANE.0b013e31824b0296     Document Type: Review

References (60)

1. Bouza C, Garcia E, Diaz M, Segovia E, Rodriguez I. Unplanned extubation in orally intubated medical patients in the intensive care unit: a prospective cohort study. Heart Lung 2007;36: 270-6 (Pubitemid 47039175)
2. Moons P, Sels K, De Becker W, De Geest S, Ferdinande P. Development of a risk assessment tool for deliberate self-extubation in intensive care patients. Intensive Care Med 2004;30:1348-55 (Pubitemid 38951717)
3. Penuelas O, Frutos-Vivar F, Esteban A. Unplanned extubation in the ICU: a marker of quality assurance of mechanical ventilation. Crit Care 2011;15:128
4. de Vos M, Graafmans W, Keesman E, Westert G, van der Voort PH. Quality measurement at intensive care units: which indicators should we use? J Crit Care 2007;22:267-74 (Pubitemid 350251099)
5. Richmond AL, Jarog DL, Hanson VM. Unplanned extubation in adult critical care: quality improvement and education payoff. Crit Care Nurse 2004;24:32-7
6. Chiang AA, Lee KC, Lee JC, Wei CH. Effectiveness of a continuous quality improvement program aiming to reduce unplanned extubation: a prospective study. Intensive Care Med 1996;22:1269-71 (Pubitemid 26405521)
7. Frezza EE, Carleton GL, Valenziano CP. A quality improvement and risk management initiative for surgical ICU patients: a study of the effects of physical restraints and sedation on the incidence of self-extubation. Am J Med Qual 2000;15:221-5
8. Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical- epidemiology/oxford.htm. Accessed August 17, 2011
9. Oxford Centre for Evidence-Based Medicine. Levels of evidence and grades of recommendation. Available at: www.cebm.net/index.aspx?o = 1025. Accessed August 17,2011
10. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74 (Pubitemid 8054849)
11. Coppolo DP, May JJ. Self-extubations: a 12-month experience. Chest 1990;98:165-9
12. Pesiri AJ. Two-year study of the prevention of unintentional extubation. Crit Care Nurs Q 1994;17:35-9 (Pubitemid 24329488)
13. Vassal T, Anh NG, Gabillet JM, Guidet B, Staikowsky F, Offenstadt G. Prospective evaluation of self-extubations in a medical intensive care unit. Intensive Care Med 1993;19:340-2 (Pubitemid 23284797)
14. Whelan J, Simpson SQ, Levy H. Unplanned extubation: predictors of successful termination of mechanical ventilatory support. Chest 1994;105:1808-12 (Pubitemid 24180674)
15. Maguire GP, DeLorenzo LJ, Moggio RA. Unplanned extubation in the intensive care unit: a quality-of-care concern. Crit Care Nurs Q 1994;17:40-7 (Pubitemid 24329489)
16. Listello D, Sessler CN. Unplanned extubation: clinical predictors for reintubation. Chest 1994;105:1496-1503 (Pubitemid 24152612)
17. Tindol GA Jr, DiBenedetto RJ, Kosciuk L. Unplanned extuba-tions. Chest 1994;105:1804-7
18. Grap MJ, Glass C, Lindamood MO. Factors related to unplanned extubation of endotracheal tubes. Crit Care Nurse 1995;15:57-65
19. Tominaga GT, Rudzwick H, Scannell G, Waxman K. Decreasing unplanned extubations in the surgical intensive care unit. Am J Surg 1995;170:586-9
20. Christie JM, Dethlefsen M, Cane RD. Unplanned endotracheal extubation in the intensive care unit. J Clin Anesth 1996;8: 289-93 (Pubitemid 26161501)
21. Atkins PM, Mion LC, Mendelson W, Palmer RM, Slomka J, Franko T. Characteristics and outcomes of patients who self-extubate from ventilatory support: a case-control study. Chest 1997;112:1317-23 (Pubitemid 27497866)
22. Achauer BM, Mueller G, Vanderkam VM. Prevention of accidental extubation in burn patients. Ann Plast Surg 1997;38:280-2 (Pubitemid 27137182)
23. Chevron V, Menard JF, Richard JC, Girault C, Leroy J, Bon-marchand G. Unplanned extubation: risk factors of development and predictive criteria for reintubation. Crit Care Med 1998;26:1049-53 (Pubitemid 28272856)
24. Betbese AJ, Perez M, Bak E, Rialp G, Mancebo J. A prospective study of unplanned endotracheal extubation in intensive care unit patients. Crit Care Med 1998;26:1180-6 (Pubitemid 28334970)
25. Boulain T. Unplanned extubations in the adult intensive care unit: a prospective multicenter study. Association des Reani-mateurs du Centre-Ouest. Am J Respir Crit Care Med 1998;157:1131-7
26. Powers J. A sedation protocol for preventing patient self-extubation. Dimens Crit Care Nurs 1999;18:30-4
27. Mort TC. Unplanned tracheal extubation outside the operating room: a quality improvement audit of hemodynamic and tracheal airway complications associated with emergency tra-cheal reintubation. Anesth Analg 1998;86:1171-6 (Pubitemid 28249230)
28. Barnason S, Graham J, Wild MC, Jensen LB, Rasmussen D, Schulz P, Woods S, Carder B. Comparison of two endotracheal tube securement techniques on unplanned extubation, oral mucosa, and facial skin integrity. Heart Lung 1998;27:409-17 (Pubitemid 28535869)
29. Epstein SK, Nevins ML, Chung J. Effect of unplanned extuba-tion on outcome of mechanical ventilation. Am J Respir Crit Care Med 2000;161:1912-6 (Pubitemid 30418129)
30. Razek T, Gracias V, Sullivan D, Braxton C, Gandhi R, Gupta R, Malcynski J, Anderson HL, Reilly PM, Schwab CW. Assessing the need for reintubation: a prospective evaluation of unplanned endotracheal extubation. J Trauma 2000;48:466-9 (Pubitemid 30183108)
31. Carrion MI, Ayuso D, Marcos M, Paz Robles M, de la Cal MA, Alia I, Esteban A. Accidental removal of endotracheal and nasogastric tubes and intravascular catheters. Crit Care Med 2000;28:63-6 (Pubitemid 30091030)
32. Kapadia FN, Bajan KB, Raje KV. Airway accidents in intubated intensive care unit patients: an epidemiological study. Crit Care Med 2000;28:659-64 (Pubitemid 30174259)
33. Jiang JS, Kao SJ, Lin CM, Yeh YW. Respiratory management after self-extubation. J Formos Med Assoc 2000;99:689-92
34. Balon JA. Common factors of spontaneous self-extubation in a critical care setting. Int J Trauma Nurs 2001;7:93-9 (Pubitemid 33077241)
35. Tung A, Tadimeti L, Caruana-Montaldo B, Atkins PM, Mion LC, Palmer RM, Slomka J, Mendelson W. The relationship of sedation to deliberate self-extubation. J Clin Anesth 2001;13:24-9 (Pubitemid 32215249)
36. Moraga EO. Impact of a programme of non-planned extuba-tion intervention at intensive care units [in Spanish]. Rev Chil Med Intensiv 2001;16:250
37. Phoa LL, Pek WY, Syap W, Johan A. Unplanned extubation: a local experience. Singapore Med J 2002;43:504-8 (Pubitemid 36104195)
38. Pandey CK, Singh N, Srivastava K, Alka R, Baronia A, Agarwal A, Singh PK. Self-extubation in intensive care and re-intubation predictors: a retrospective study. J Indian Med Assoc 2002;100:11, 14-6
39. de Lassence A, Alberti C, Azoulay E, Le Miere E, Cheval C, Vincent F, Cohen Y, Garrouste-Orgeas M, Adrie C, Troche G, Timsit JF; OUTCOMEREA Study Group. Impact of unplanned extubation and reintubation after weaning on nosocomial pneumonia risk in the intensive care unit: a prospective multicenter study. Anesthesiology 2002;97:148-56 (Pubitemid 34733934)
40. Chen CZ, Chu YC, Lee CH, Chen CW, Chang HY, Hsiue TR. Factors predicting reintubation after unplanned extubation. J Formos Med Assoc 2002;101:542-6
41. Yeh SH, Lee LN, Ho TH, Chiang MC, Lin LW. Implications of nursing care in the occurrence and consequences of unplanned extubation in adult intensive care units. Int J Nurs Stud 2004;41:255-62
42. Chatterjee AS, Islam S, Divatia JV. Airway accidents in an intensive care unit. Indian J Crit Care Med 2004;8:36-9
43. Krinsley JS, Barone JE. The drive to survive: unplanned extubation in the ICU. Chest 2005;128:560-6 (Pubitemid 41140480)
44. Bhattacharya P, Chakraborty A, Agarwal P. Comparison of outcome of self-extubation and accidental extubation in ICU. Indian J Crit Care Med 2007;11:105-8 (Pubitemid 47538153)
45. Moons P, Boriau M, Ferdinande P. Self-extubation risk assessment tool: predictive validity in a real-life setting. Nurs Crit Care 2008;13:310-4
46. Chang LY, Wang KW, Chao YF. Influence of physical restraint on unplanned extubation of adult intensive care patients: a case-control study. Am J Crit Care 2008;17:408-15
47. Curry K, Cobb S, Kutash M, Diggs C. Characteristics associated with unplanned extubations in a surgical intensive care unit. Am J Crit Care 2008;17:45-51
48. Eryüksel E, Karakurt S, Celikel T. Noninvasive positive pressure ventilation in unplanned extubation. Ann Thorac Med 2009;4:17-20
49. Castellões TM, da Silva LD. Nursing interventions for the prevention of accidental extubation [in Portuguese]. Rev Bras Enferm 2009;62:540-5
50. Ayllón Garrido N, Rodríguez Borrajo MJ, Soleto PG, Latorre García PM. Unplanned extubations in patients in the ventilator weaning phase in the intensive care unit: incidence and risk factors [in Spanish]. Enferm Clin 2009;19:210-4
51. Huang YT. Factors leading to self-extubation of endotracheal tubes in the intensive care unit. Nurs Crit Care 2009;14:68-74
52. Chang LC, Liu PF, Huang YL, Yang SS, Chang WY. Risk factors associated with unplanned endotracheal self-extubation of hospitalized intubated patients: a 3-year retrospective case-control study. Appl Nurs Res 2011;24:188-92
53. Elmetwally R, Elshafey M, Zeidan A, Makharita MY. Predictors and outcome of unplanned extubation in COPD patients. Egypt J Anaesth 2010;26:1-11
54. Chen CM, Chan KS, Fong Y, Hsing SC, Cheng AC, Sung MY, Su MY, Cheng KC. Age is an important predictor of failed unplanned extubation. Int J Gerontol 2010;4:120-9
55. de Groot RI, Dekkers OM, Herold IH, de Jonge E, Arbous MS. Risk factors and outcomes after unplanned extubations on the ICU: a case-control study. Crit Care 2011;15:R19
56. Hofso K, Coyer FM. Part 2. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: a patient perspective. Intensive Crit Care Nurs 2007;23:316-22
57. Maccioli GA, Dorman T, Brown BR, Mazuski JE, McLean BA, Kuszaj JM, Rosenbaum SH, Frankel LR, Devlin JW, Govert JA, Smith B, Peruzzi WT; American College of Critical Care Medicine, Society of Critical Care Medicine. Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit: use of restraining therapies\American College of Critical Care Med Task Force 2001-2002. Crit Care Med 2003;31:2665-76 (Pubitemid 37452848)
58. Ely EW, Baker AM, Dunagan DP, Burke HL, Smith AC, Kelly PT, Johnson MM, Browder RW, Bowton DL, Haponik EF. Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 1996;335:1864-9 (Pubitemid 26419193)
59. Alspach G. Nurse staffing and patient outcomes. This is news? Crit Care Nurse 2003;23:14-5
60. da Silva PS, de Aguiar VE, Neto HM, de Carvalho WB. Unplanned extubation in a paediatric intensive care unit: impact of a quality improvement programme. Anaesthesia 2008;63:1209-16