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Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study
BACKGROUND AND AIMS: The objective of the study was to determine the incidence of failed extubations in our Intensive Care Unit (ICU) and identify associated clinical factors. MATERIALS AND METHODS: A prospective observational study of mechanically ventilated patients who underwent extubation attemp...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363101/ https://www.ncbi.nlm.nih.gov/pubmed/28400683 http://dx.doi.org/10.4103/ijccm.IJCCM_452_16 |
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author | Hsiung Lee, Eric Shih Jiann Lim, Danny Tse Taculod, Juvel Mabao Sahagun, Juliet Tolentino Otero, Joerie Pasive Teo, Kaimin Loh, Will Ne-Hooi Hui Tan, Addy Yong |
author_facet | Hsiung Lee, Eric Shih Jiann Lim, Danny Tse Taculod, Juvel Mabao Sahagun, Juliet Tolentino Otero, Joerie Pasive Teo, Kaimin Loh, Will Ne-Hooi Hui Tan, Addy Yong |
author_sort | Hsiung Lee, Eric Shih |
collection | PubMed |
description | BACKGROUND AND AIMS: The objective of the study was to determine the incidence of failed extubations in our Intensive Care Unit (ICU) and identify associated clinical factors. MATERIALS AND METHODS: A prospective observational study of mechanically ventilated patients who underwent extubation attempts in our (predominantly surgical) ICU was undertaken from July 2012 to August 2013. The primary endpoint was the need for nonelective reintubation within 72 h of extubation. Clinical data of the reintubated patients were compared with those who were successfully extubated to identify factors associated with reintubation. RESULTS: Five hundred and eight extubation attempts were documented, 38 (7.5%) of which were unsuccessful. On multivariate analysis, the following clinical factors were found to be associated with an increased risk of failed extubation: unplanned extubations (adjusted odds ratio [OR] 5.8), the use of noninvasive ventilation (NIV) postextubation (adjusted OR 3.2), and sepsis (adjusted OR 2.9). Patient demographic factors, other premorbid and comorbid medical conditions, and differences of laboratory parameters did not appear to significantly influence reintubation rates in our study. CONCLUSIONS: Our study has demonstrated a relatively low reintubation rate, likely due to inclusion of elective admissions/intubations in our patient population. Unplanned extubations, the use of NIV postextubation, and sepsis were associated with increased reintubation risk, reinforcing the need for increased vigilance in this subgroup of patients after extubation. |
format | Online Article Text |
id | pubmed-5363101 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-53631012017-04-11 Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study Hsiung Lee, Eric Shih Jiann Lim, Danny Tse Taculod, Juvel Mabao Sahagun, Juliet Tolentino Otero, Joerie Pasive Teo, Kaimin Loh, Will Ne-Hooi Hui Tan, Addy Yong Indian J Crit Care Med Research Article BACKGROUND AND AIMS: The objective of the study was to determine the incidence of failed extubations in our Intensive Care Unit (ICU) and identify associated clinical factors. MATERIALS AND METHODS: A prospective observational study of mechanically ventilated patients who underwent extubation attempts in our (predominantly surgical) ICU was undertaken from July 2012 to August 2013. The primary endpoint was the need for nonelective reintubation within 72 h of extubation. Clinical data of the reintubated patients were compared with those who were successfully extubated to identify factors associated with reintubation. RESULTS: Five hundred and eight extubation attempts were documented, 38 (7.5%) of which were unsuccessful. On multivariate analysis, the following clinical factors were found to be associated with an increased risk of failed extubation: unplanned extubations (adjusted odds ratio [OR] 5.8), the use of noninvasive ventilation (NIV) postextubation (adjusted OR 3.2), and sepsis (adjusted OR 2.9). Patient demographic factors, other premorbid and comorbid medical conditions, and differences of laboratory parameters did not appear to significantly influence reintubation rates in our study. CONCLUSIONS: Our study has demonstrated a relatively low reintubation rate, likely due to inclusion of elective admissions/intubations in our patient population. Unplanned extubations, the use of NIV postextubation, and sepsis were associated with increased reintubation risk, reinforcing the need for increased vigilance in this subgroup of patients after extubation. Medknow Publications & Media Pvt Ltd 2017-03 /pmc/articles/PMC5363101/ /pubmed/28400683 http://dx.doi.org/10.4103/ijccm.IJCCM_452_16 Text en Copyright: © 2017 Indian Journal of Critical Care Medicine 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-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Research Article Hsiung Lee, Eric Shih Jiann Lim, Danny Tse Taculod, Juvel Mabao Sahagun, Juliet Tolentino Otero, Joerie Pasive Teo, Kaimin Loh, Will Ne-Hooi Hui Tan, Addy Yong Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study |
title | Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study |
title_full | Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study |
title_fullStr | Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study |
title_full_unstemmed | Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study |
title_short | Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study |
title_sort | factors associated with reintubation in an intensive care unit: a prospective observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363101/ https://www.ncbi.nlm.nih.gov/pubmed/28400683 http://dx.doi.org/10.4103/ijccm.IJCCM_452_16 |
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