The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

A COMPARISON OF UNPLANNED EXTUBATIONS RATES IN MEDICAL/CARDIAC VS. SURGICAL INTENSIVE CARE UNITS

Roberta Braun, BS, RCP, RRT Russell Reid, BBA, RCP, RRT, CPFT Carolinas Medical Center, Charlotte, NC

Hypothesis: There is no difference in the Unplanned Extubation rate for patients undergoing mechanical ventilation in Medical/Cardiac vs. Surgical units when adjusted for the number of mechanical ventilator days.

Description of Research Design: This study was a single center, nonrandomized, retrospective examination of patients that experienced unplanned extubations while undergoing mechanical ventilation in one of five units over a two year period. The units were classified as either Medical/Cardiac or Surgery based upon the primary type of care delivered by the unit.

Findings: Table 1 contains the data collected for the two groups. The Medical/Cardiac group consisted of a MICU and CCU, while the Surgical group was composed of a SICU, TICU and NSICU. A two tailed, Student's T-test for samples of unequal variance was used to analyze the monthly extubations rates between the two groups. The Student's T statistic was -1.97.

  Mean Extubation Rate (+ SD ) Median Extubation Rate Total Ventilator Days Total Number of Extubations
Medical/Cardiac *1.2 % (± 0.7 %) 1.1 % 11,909.8 136
Surgical *1.6 % (± 0.7 %) 1.5% 9,721.7 148
Combined Group Values Mean = 1.3% NA Total =21,631.5 Total = 284

Table 1. Summary values for unplanned extubations between Medical/Cardiac and Surgical groups of patients. * Statistically significant (p = 0.05)

Summary of Conclusions: There were statistically significant differences between the Medical/Cardiac and Surgical groups within this study. Surgical mechanically ventilated patients experienced a greater unplanned extubation rate compared to mechanically ventilated patients in the medical group. Based upon this study data the Surgical group would be expected to have approximately 4 more unplanned extubations per 1000 ventilator days than the Medical group. The reasons for the greater unplanned extubation rate in the Surgical group could be due to differences in level of sedation, the application of restraints, staffing levels/ratios, the timeliness of weaning and other myriad factors that require further investigation.

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