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A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit

BACKGROUND: Self-extubation is a common event in intensive care units (ICUs) world-wide. The most common factor attributed in various studies is lack of optimal sedation. However, the factors that lead to this inadequacy of sedation are not analyzed. AIMS: The present study aimed to evaluate the det...

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Autores principales: Singh, Preet Mohinder, Rewari, Vimi, Chandralekha, Arora, Mahesh Kumar, Trikha, Anjan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841529/
https://www.ncbi.nlm.nih.gov/pubmed/24339655
http://dx.doi.org/10.4103/0974-2700.120363
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author Singh, Preet Mohinder
Rewari, Vimi
Chandralekha,
Arora, Mahesh Kumar
Trikha, Anjan
author_facet Singh, Preet Mohinder
Rewari, Vimi
Chandralekha,
Arora, Mahesh Kumar
Trikha, Anjan
author_sort Singh, Preet Mohinder
collection PubMed
description BACKGROUND: Self-extubation is a common event in intensive care units (ICUs) world-wide. The most common factor attributed in various studies is lack of optimal sedation. However, the factors that lead to this inadequacy of sedation are not analyzed. AIMS: The present study aimed to evaluate the determinants of factors leading to self-extubation in our ICU. Relation of patient profile, nature of sedation and any diurnal variation in extubation frequency was analyzed MATERIALS AND METHODS: Retrospective explorative analysis was carried out for patients admitted to ICU from January 2011 to January 2012. Information from medical records for the above parameters was extracted and descriptive statistics was used for assessing the outcomes. RESULTS: In the present study, there was a higher incidence of self-extubation in ventilated ICU patients during the changeover periods of the ICU staff. There was no relation of frequency of self-extubation with the medications used for sedation once the sedation was titrated to a common endpoint. A higher incidence of self-extubation was seen in the surgical and younger age group of patients. CONCLUSIONS: It is recommended that the duty shift finishing time of ICU staff (medical and paramedical) staff should be staggered and should have minimal overlap to prevent self-extubation. A continuous reassessment of level of sedation of patients independent of the type sedative medication should be carried out.
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spelling pubmed-38415292013-12-11 A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit Singh, Preet Mohinder Rewari, Vimi Chandralekha, Arora, Mahesh Kumar Trikha, Anjan J Emerg Trauma Shock Original Article BACKGROUND: Self-extubation is a common event in intensive care units (ICUs) world-wide. The most common factor attributed in various studies is lack of optimal sedation. However, the factors that lead to this inadequacy of sedation are not analyzed. AIMS: The present study aimed to evaluate the determinants of factors leading to self-extubation in our ICU. Relation of patient profile, nature of sedation and any diurnal variation in extubation frequency was analyzed MATERIALS AND METHODS: Retrospective explorative analysis was carried out for patients admitted to ICU from January 2011 to January 2012. Information from medical records for the above parameters was extracted and descriptive statistics was used for assessing the outcomes. RESULTS: In the present study, there was a higher incidence of self-extubation in ventilated ICU patients during the changeover periods of the ICU staff. There was no relation of frequency of self-extubation with the medications used for sedation once the sedation was titrated to a common endpoint. A higher incidence of self-extubation was seen in the surgical and younger age group of patients. CONCLUSIONS: It is recommended that the duty shift finishing time of ICU staff (medical and paramedical) staff should be staggered and should have minimal overlap to prevent self-extubation. A continuous reassessment of level of sedation of patients independent of the type sedative medication should be carried out. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3841529/ /pubmed/24339655 http://dx.doi.org/10.4103/0974-2700.120363 Text en Copyright: © Journal of Emergencies, Trauma, and Shock http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Singh, Preet Mohinder
Rewari, Vimi
Chandralekha,
Arora, Mahesh Kumar
Trikha, Anjan
A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
title A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
title_full A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
title_fullStr A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
title_full_unstemmed A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
title_short A retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
title_sort retrospective analysis of determinants of self-extubation in a tertiary care intensive care unit
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841529/
https://www.ncbi.nlm.nih.gov/pubmed/24339655
http://dx.doi.org/10.4103/0974-2700.120363
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