Objective: When unplanned extubation (UE) occurs in intensive care patients, mechanical ventilation is negatively affected. In this study, we aimed to investigate the characteristics of UE patients, the duration of extubation, and the characteristics of reintubation patients.
Material and Methods: In this retrospective cohort study of UE patients between May 1, 2010 and December 31, 2012, reintubation patients were included in Group 1 (n=12) and patients who did not require reintubation were included in Group 2 (n=12). The demographic features, mechanical ventilation mode, UE cause (patient/staff), APACHE II score, presence of ventilator-associated pneumonia, extubation time, sedation requirement, NIV requirement after extubation, and need of reintubation were recorded. Patients in groups 1 and 2 were compared in terms of risk factors for reintubation.
Results: Twenty-four patients (23 males) were included. Their median age was 75 years (range, 56-81 years) [Group 1=79 years (range, 74-81 years) and Group2=62 years (range, 56-76 years)]. The APACHE II score was significantly higher in Group 1 patients than in Group 2 patients (27 vs. 23, p=0.03). The pH was significantly lower in Group 1 (7.26 vs. 7.35, p=0.008). Weaning success was significantly lower and mortality was significantly higher in Group 1 patients than in Group 2 patients (1/12 vs. 8/12, p=0.003 and 11/12 vs. 1/12, p=0.0001, respectively). The number of patients with ventilator-associated pneumonia was higher in Group 1 than in Group 2 (7/12 vs 2/12, p=0.035). NIV was applied to all patients except one.
Conclusion: Unplanned extubation is an undesirable condition in intensive care. Patients with advanced age and higher APACHE II scores may be at a high risk of reintubation and mortality.