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Unplanned extubation

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...
September 19, 2016: 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...
May 21, 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
Jack C Buckley, Adam P Brown, John S Shin, Kirsten M Rogers, Nir N Hoftman
BACKGROUND: Endotracheal tube security is a critical safety issue. We compared the mobility of an in situ endotracheal tube secured with adhesive tape to the one secured with a new commercially available purpose-designed endotracheal tube-holder device (Haider Tube-Guard). We also observed for the incidence of oropharyngeal or facial trauma associated with the 2 tube fixation methods. METHODS: Thirty adult patients undergoing general anesthesia with neuromuscular blockade were prospectively enrolled...
May 2016: Anesthesia and Analgesia
Michele Carron, Francesco Zarantonello, Paola Tellaroli, Carlo Ori
BACKGROUND: Perioperative noninvasive ventilation (NIV) has been proposed to reduce postoperative morbidity and improve perioperative outcomes in patients undergoing general anesthesia. Whether it is advantageous to apply NIV just before and after general anesthesia in obese patients has not been yet established. OBJECTIVES: To perform a qualitative review and meta-analysis to assess the effectiveness and tolerability of perioperative NIV in obese patients. METHODS: All studies in English language performed in clinical setting that compared the application of NIV with standard care just before and after induction of general anesthesia in obese adults (body mass index [BMI]≥35 kg/m(2)) were included...
March 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Michele Carron, Fabio Baratto, Francesco Zarantonello, Carlo Ori
OBJECTIVE: The aim of the study is to evaluate the clinical and economic impact of introducing a rocuronium-neostigmine-sugammadex strategy into a cisatracurium-neostigmine regimen for neuromuscular block (NMB) management. METHODS: We conducted a retrospective analysis of clinical outcomes and cost-effectiveness in five operating rooms at University Hospital of Padova. A clinical outcome evaluation after sugammadex administration as first-choice reversal drug in selected patients (rocuronium-sugammadex) and as rescue therapy after neostigmine reversal (rocuronium-neostigmine-sugammadex) compared to control was performed...
2016: ClinicoEconomics and Outcomes Research: CEOR
T D Fontánez-Nieves, M Frost, E Anday, D Davis, D Cooperberg, A J Carey
OBJECTIVE: Unplanned extubation events (UPEs) in neonates are hazardous to patient safety. Our goal was to reduce UPE rate (#UPEs per 100 ventilator days) by 50% in 12 months at our 25-bed level III inborn unit. STUDY DESIGN: Baseline data were gathered prospectively for 7 months. Three Plan-Do-Study-Act (PDSA) cycles targeting main causes of UPEs were developed over the next 20 months. Causes of UPEs were analyzed using Pareto charts; and a U control chart was created with QI Charts(©)...
June 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Sandeep Tripathi, Mike H Ushay
No abstract text is available yet for this article.
December 2015: Respiratory Care
Shari Toomey
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Mia Maamari, Atul Vats, James Fortenberry, Clara Hopkins, Patrick Spafford, Karen Walson, Pradip Kamat
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Kusum Menon, Belinda Dundon, Betty-Lou Twolan, Salman AlShammari
UNLABELLED: An unplanned extubation is defined as an extubation that occurs at a time other than that planned for the procedure. It may result in life-threatening complications such as laryngospasm, pulmonary or cardiac failure. Quality improvement initiatives have targeted an unplanned extubation rate of 0% in pediatric intensive care units. OBJECTIVE: To determine if a targeted approach specific to local practices and unit culture could decrease the incidence of and, ultimately, eliminate unplanned extubations in our tertiary care PICU...
2015: Canadian Journal of Critical Care Nursing
L Dupree Hatch, Peter H Grubb, Amanda S Lea, William F Walsh, Melinda H Markham, Gina M Whitney, James C Slaughter, Ann R Stark, E Wesley Ely
OBJECTIVE: To determine the rate of adverse events associated with endotracheal intubation in newborns and modifiable factors contributing to these events. STUDY DESIGN: We conducted a prospective, observational study in a 100-bed, academic, level IV neonatal intensive care unit from September 2013 through June 2014. We collected data on intubations using standardized data collection instruments with validation by medical record review. Intubations in the delivery or operating rooms were excluded...
January 2016: Journal of Pediatrics
Paulo Sérgio Lucas da Silva, Werther Brunow de Carvalho, Marcelo Cunio Machado Fonseca
No abstract text is available yet for this article.
November 2015: Pediatric Critical Care Medicine
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