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Unplanned extubation

J B Huang, C Q Lan, H Y Li, L Chen, J G Pan, L L Chen, H Weng, Y M Zeng
Objective: To study the value of an early (mechanical ventilation after 24 h) non-sedation protocol for intubated, mechanically ventilated patients in the respiratory intensive care unit (RICU). Methods: Seventy intubated, mechanically ventilated patients were prospectively enrolled and randomly assigned to management with early non-sedation (intervention group; n=35) or with daily interruption of sedation (DIS) (control group; n=35). The duration of mechanical ventilation, length of the RICU and hospital stay, RICU and hospital mortality, drug consumption, RICU and hospitalization expenses, incidence of complications and adverse events and serum levels of vital organ damage and inflammatory markers after mechanical ventilation for 48 h were recorded and compared...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
S Mbi Ndakor, M U Nelson, J M B Pinheiro
OBJECTIVE: To assess if neonatologists detect and count unplanned extubations (UEs) uniformly. STUDY DESIGN: An Institutional Review Board-exempted anonymous web-based survey of neonatology attending and fellow members of the AAP Neonatal-Perinatal Medicine section was administered. Respondents were queried on practices concerning UE; they were then presented with different case scenarios and asked if they would count the event as a UE. RESULTS: Of the 509 respondents, 61% track UE rates...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
Bonnie M Powell, Edeltraud Gilbert, Teresa A Volsko
BACKGROUND: Unplanned extubations can lead to iatrogenic injury and have the potential to contribute to serious safety events. We adopted lean methodology to reduce the unplanned extubation rate in a Level 3b NICU. We hypothesized that the use of a rapid-cycle PDSA (plan, do, study, act) initiative would reduce the unplanned extubation rate. METHODS: Baseline unplanned extubation data were collected from November 1, 2012 to June 6, 2014. A voice of the customer survey ascertained perceptions regarding unplanned extubation causes and impact on care...
December 2016: Respiratory Care
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
Hui-Ying Chiang, Ya-Chu Hsiao, Huan-Fang Lee
Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices...
November 21, 2016: Journal of Nursing Care Quality
Wyn Wheeler, Dwight Bailey
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Edward Lane, Hailey Kuzow, Angel Manguera, Robert Perry, Mohamed Mansour
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Claudia Kunrath, Sandy Sedgley, Heidi Bliss, Rebecca Kalivas, Renee Roybal, Andrea Ellis, Carol Okada, Nivedita Mohari
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Stacy Hevener, Barbara Rickabaugh, Toby Marsh
BACKGROUND: Little information is available on the use of tools in intensive care units to help nurses determine when to restrain a patient. Patients in medical-surgical intensive care units are often restrained for their safety to prevent them from removing therapeutic devices. Research indicates that restraints do not necessarily prevent injuries or removal of devices by patients. OBJECTIVES: To decrease use of restraints in a medical-surgical intensive care unit and to determine if a decision support tool is useful in helping bedside nurses determine whether or not to restrain a patient...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Prakash K Loganathan, Vrinda Nair, Mike Vine, Linda Kostecky, Derek Kowal, Amuchou Soraisham
OBJECTIVES: To examine the rate of unplanned extubation (UE) after the introduction of NeoBar (endotracheal tube stabilization device) compared to the previous tapping method and to analyze the factors associated with UE in the neonatal intensive care unit (NICU). METHODS: A quality improvement study was conducted in a tertiary NICU between October 2011 and December 2013. In October 2012, after many educational sessions NeoBar was introduced as a tool for securing endotracheal tube...
January 2017: Indian Journal of Pediatrics
Anair Beverly, Ethan Y Brovman, Raymond J Malapero, Robert W Lekowski, Richard D Urman
OBJECTIVES: To determine the incidence, timing, risk factors for, and outcomes after unplanned reintubation following cardiac surgery in adults. DESIGN: Retrospective analysis of admission data from the American College of Surgeons National Surgical Quality Improvement Project Database, 2007-2013, inclusive. Univariate and multivariate analyses of risk factors and outcomes. PARTICIPANTS: A total of 18,571 patients, over 18 years of age, undergoing cardiac surgery...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mickael Vourc'h, Fanny Feuillet, Pierre-Joachim Mahe, Véronique Sebille, Karim Asehnoune
BACKGROUND: Alcohol is the leading psychoactive substance consumed in France, with about 15 million regular consumers. The National institute on Alcohol Abuse and Alcoholism (NIAAA) considers alcohol abuse to be more than 14 units of alcohol a week for men and 7 units for women. The specific complication of alcoholism is the alcohol withdrawal syndrome. Its incidence reaches up to 30 % and its main complications are delirium tremens, restlessness, extended hospital stay, higher morbidity, and psychiatric and cognitive impairment...
August 19, 2016: Trials
Christophe Faisy, Cindy Davagnar, Dominique Ladiray, Juliette Djadi-Prat, Maxime Esvan, Emilie Lenain, Pierre Durieux, Jean-François Leforestier, Carine Marlet, Marta Seijo, Anne Guillou
OBJECTIVE: Our purpose was to identify potential organizational factors that contributed to life-threatening adverse events in adult intensive care unit. METHODS: A prospective, observational, dynamic cohort study was carried out from January 2006 to December 2013 in a 20-bed adult medical intensive care unit. All patients admitted to the intensive care unit and who experienced one or more selected life-threatening adverse events (mainly unexpected cardiac arrest, unplanned extubation, reintubation after planned extubation, and readmission within 48h of intensive care unit discharge) were included in the analysis...
October 2016: International Journal of Nursing Studies
Fan Gao, Li-Hong Yang, Hai-Rong He, Xian-Cang Ma, Jun Lu, Ya-Jing Zhai, Li-Tao Guo, Xue Wang, Jie Zheng
OBJECTIVES: This meta-analysis summarized the risks that reintubation impose on ventilator-associated pneumonia (VAP) and mortality. BACKGROUND: Extubation failure increases the probability of poor clinical outcomes pertaining to mechanical ventilation. METHODS: Literature published during a 15-year period was retrieved from PubMed, Web of Knowledge databases, the Embase (Excerpa Medica database), and the Cochrane Library. Data involving reintubation, VAP, and mortality were extracted for a meta-analysis...
July 2016: Heart & Lung: the Journal of Critical Care
Dilek Yazıcıoğlu Ünal, İlkay Baran, Murad Mutlu, Gülçin Ural, Taylan Akkaya, Onur Özlü
OBJECTIVE: To compare sugammadex and neostigmine regarding the efficacy in reversing rocuronium-induced neuromuscular block, the incidence of post-operative respiratory complications and costs in patients undergoing surgery for the treatment of obstructive sleep apnoea (OSA). METHODS: After obtaining ethical approval and patient consent, 74 patients in ASA physical status I or II were randomised into two groups to receive 2-mg kg(-1) sugammadex (Group S) or 0.04-mg kg(-1) neostigmine+0...
December 2015: Turkish Journal of Anaesthesiology and Reanimation
S Gelvez-Zapata, R D'Oliveiro, J Osgathorpe, J Lonsdale, M Petty, N Jones
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Yuxia Zhang, Linxia Liu, Jing Hu, Yanhong Zhang, Guoping Lu, Guangyu Li, Zelan Zuo, Hua Lu, Huan Zou, Zaihua Wang, Quelan Huang
BACKGROUND: Nursing-sensitive indicators are considered effective tools for improving the quality of care in hospitals. However, these have not been used in paediatric intensive care units (PICUs) in China. AIM: To develop nursing-sensitive indicators for PICUs and to assess the quality of nursing in PICUs in China based on the nursing-sensitive indicators. DESIGN: Multi-centre, cross-sectional study. METHODS: Structure, process and outcome indicators were developed and measured from 1 January to 31 March 2014 in seven PICUs in China...
May 23, 2016: Nursing in Critical Care
A-C Falk, E-M Wallin
BACKGROUND: Intensive care is one of the most resource-intensive forms of medical care due to severely ill patients that are cared for in units with high staffing levels. Nursing's impact on the health of patients has shown that the number of nurses per patient and nurse education effects patient outcome. However, there are a lack of studies investigating highly specialised nurses in intensive care and their relation to patient outcome. METHOD: This is a retrospective study of critical care registry data (all patients >15 years) in general critical care units at seven university hospitals...
August 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Sugata Dasgupta, Shipti Shradha Singh, Arunima Chaudhuri, Dipasri Bhattacharya, Sourav Das Choudhury
BACKGROUND: Although tracheal tubes are essential devices to control and protect airway in a critical care unit (CCU), they are not free from complications. AIMS: To document the incidence and nature of airway accidents in the CCU of a government teaching hospital in Eastern India. METHODS: Retrospective analysis of all airway accidents in a 5-bedded (medical and surgical) CCU. The number, types, timing, and severity of airway accidents were analyzed...
February 2016: Indian Journal of Critical Care Medicine
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