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Unplanned extubation

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https://www.readbyqxmd.com/read/28400683/factors-associated-with-reintubation-in-an-intensive-care-unit-a-prospective-observational-study
#1
Eric Shih Hsiung Lee, Danny Tse Jiann Lim, Juvel Mabao Taculod, Juliet Tolentino Sahagun, Joerie Pasive Otero, Kaimin Teo, Will Ne-Hooi Loh, Addy Yong Hui Tan
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...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28400408/incidence-and-risk-factors-for-cardiovascular-collapse-after-unplanned-extubations-in-the-pediatric-icu
#2
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for ≥12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE...
April 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28388984/case-control-study-on-risk-factors-of-unplanned-extubation-based-on%C3%A2-patient-safety-model-in-critically-ill-patients-with-mechanical-ventilation
#3
EunOk Kwon, KyungSook Choi
PURPOSE: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. METHODS: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay...
March 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28341980/implementation-and-evaluation-of-a-paediatric-nurse-driven-sedation-protocol-in-a-paediatric-intensive-care-unit
#4
Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet, Fabienne Bordet
BACKGROUND: Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28297813/-clinical-application-and-evaluation-of-an-early-non-sedation-protocol-for-critically-ill-respiratory-patients
#5
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
https://www.readbyqxmd.com/read/28151492/counting-unplanned-extubations-marked-variation-among-neonatologists
#6
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
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#7
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
https://www.readbyqxmd.com/read/27899538/reducing-unplanned-extubations-in-the-nicu-using-lean-methodology
#8
EDITORIAL
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
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#9
REVIEW
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
https://www.readbyqxmd.com/read/27875383/predictors-of-hospital-nurses-safety-practices-work-environment-workload-job-satisfaction-and-error-reporting
#10
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
https://www.readbyqxmd.com/read/27850875/1239-reducing-unplanned-extubations-in-a-pediatric-intensive-care-unit-through-focus-on-sedation-practice
#11
Wyn Wheeler, Dwight Bailey
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850779/1142-mitts-before-wrists-safety-mitts-reduce-restraint-usage-and-can-decrease-unplanned-self-extubations
#12
Edward Lane, Hailey Kuzow, Angel Manguera, Robert Perry, Mohamed Mansour
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850769/1132-reducing-and-sustaining-a-lower-incidence-of-unplanned-extubations-in-a-community-hospital-picu
#13
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
https://www.readbyqxmd.com/read/27802948/using-a-decision-wheel-to-reduce-use-of-restraints-in-a-medical-surgical-intensive-care-unit
#14
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
https://www.readbyqxmd.com/read/27641975/quality-improvement-study-on-new-endotracheal-tube-securing-device-neobar-in-neonates
#15
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
https://www.readbyqxmd.com/read/27595531/unplanned-reintubation-following-cardiac-surgery-incidence-timing-risk-factors-and-outcomes
#16
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
https://www.readbyqxmd.com/read/27542731/baclofen-to-prevent-agitation-in-alcohol-addicted-patients-in-the-icu-study-protocol-for-a-randomised-controlled-trial
#17
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
https://www.readbyqxmd.com/read/27455207/nurse-workload-and-inexperienced-medical-staff-members-are-associated-with-seasonal-peaks-in-severe-adverse-events-in-the-adult-medical-intensive-care-unit-a-seven-year-prospective-study
#18
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
https://www.readbyqxmd.com/read/27377334/the-effect-of-reintubation-on-ventilator-associated-pneumonia-and-mortality-among-mechanically-ventilated-patients-with-intubation-a-systematic-review-and-meta-analysis
#19
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
https://www.readbyqxmd.com/read/27366535/comparison-of-sugammadex-versus-neostigmine-costs-and-respiratory-complications-in-patients-with-obstructive-sleep-apnoea
#20
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
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