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• W4387477424 abstract "Introduction Self-extubation is reported as one of the most common events in the adult intensive care units worldwide. The aim of this study is to find out the incidence and determinants of self-extubation in a tertiary care surgical intensive care unit. Methods It was retrospective analysis data acquired from the hospital databases, who were self-extubated in surgical intensive care unit during six calendar years from January 1st, 2010, through December 31st, 2016. Data collection form was used to collect personal details, drugs used for sedation, sedation agitation score, pain score, nurse ratio and use of restrained at a time of extubation have been noted. Results Total of 618 patients were admitted to the SICU who required mechanical ventilation during the six calendar years. An overall 2.1% incidence of self-extubation was calculated with a documented thirteen self-extubation episodes. The mean age of patients was 38.46 ± 16.97 years with majority of them being males. Most of the patients at the time of self-extubation were not restrained 9(69.2%). Nurse to patient ratio was also found to be 1:1. Majority of patients 7(53.8%) were not on any sedative drug infusion and the mean sedation agitation score at that time was 4.46± 2.02 while mean pain score was 5.31 ± 2.72. Reintubation was performed in most patients 10 (76.9%) who had self-extubation. Discussion The incidence of self-extubation in ICU was 2.1%. This relatively low incidence can be elucidated by the optimal nurse-to-patient ratio in ourhospital. As nursing care is the major contributing factor that can increase the probability of self-extubation during the absence of bedside nurse. It was found that an ICU nurse with an experience of more than 4 yearscan decrease the incidence of self-extubation by 2.6%. Among numerous risk factors, agitation is responsible for 50%-74% of the unplanned extubation, while in comparison to non-agitated patients, the self-extubation rate increases by 26%. Other factors that increase the risk of self-extubation include male sex, older age, postsurgical and sedation given as per need rather than as a continuous infusion. Self-extubation can compromise airway due to the sudden removal of inflated cuff endotracheal tube which could cause difficult reintubation,hypotension, arrhythmias, bronchospasm, aspiration, and laryngeal bleeding or edema. Self-extubation can compromise airway due to the sudden removal of inflated cuff endotracheal tube which could cause difficult reintubation,hypotension, arrhythmias, bronchospasm, aspiration, and laryngeal bleeding or edema Self-extubation can compromise airway due to the sudden removal of inflated cuff endotracheal tube which could cause difficult reintubation,hypotension, arrhythmias, bronchospasm, aspiration, and laryngeal bleeding or edema" @default.
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• W4387477424 date "2023-10-01" @default.
• W4387477424 modified "2023-10-16" @default.
• W4387477424 title "Incidence and determinants of self-extubation in a tertiary care surgical intensive care unit of Pakistan. A retrospective analysis" @default.
• W4387477424 doi "https://doi.org/10.1053/j.jvca.2023.08.065" @default.
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