The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

NUMBER OF DAYS ON MECHANICAL VENTILATION PRIOR TO UNPLANNED EXTUBATION ASSOCIATED WITH A HIGHER RATE OF REINTUBATION

V. Subramaniam1, P. Kaplan1, B. Carlin1, L. Laux1, J. Weimerskirch1

Background:
Reintubation after unplanned extubation is known to have a direct correlation with increased amount of time on mechanical ventilation, development of ventilator associated pneumonia, length of ICU stay and overall length of hospital stay. Prior studies have shown that PaO2/FiO2 ratio, age of patient, mode of ventilation at time of event are significant risk factors associated with higher reintubation rates. We reviewed our institution’s experience in evaluating factors associated with the need for reintubation after unplanned extubation.

Method:
We performed a 14 month prospective observational study looking at risk factors for reintubation after unplanned extubation. The following information was obtained at the time of unplanned extubation: age, gender, number of days on the ventilator prior to event, type of unplanned extubation, type of tube securing device, use of restraints and concomitant tube feeds.

Results:
A total of 44 unplanned extubations occurred during the study period. 10 of these were excluded for incomplete data. Thirty four cases (mean age 54 years and 34% female) were included in the study. Of the 34 cases, 11 (32%) were reintubated after unplanned extubation. A stepwise multiple regression was performed using reintubation as the dependent variable. Longer length of time on the ventilator prior to unplanned extubation was found to be a significant factor in regards to reintubation rate (P 0.026). The reintubated group averaged 6.6 days of mechanical ventilation prior to unplanned extubation while the non reintubated group had averaged 2.8 days of mechanical ventilation prior to unplanned extubation.

Conclusion:
In our institution, longer length of mechanical ventilation prior to unplanned extubation was associated with a higher incidence of reintubation.

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