unplanned versus planned extubation in respiratory intensive care unit, predictors of outcome

this study was carried out to define the profile of patients at risk of unplanned extubation which is the premature removal of the E/T tube either self – inflicted by the patients or removed accidentally removed during nursing care, Also to deliver certain parameters able to predict the need of reintubation.67 mechanically ventilated patients were included in this study and were classified into two groups:Group I : planned extubation they were 40 patientsGroup II : unplanned extubation they were 27 patientsBoth groups were matched as regards age, sex, cause of admission and associated co morbidity.The most important risk factors for unplanned extubation were agitation, use of physical restraints, lack of sedation, mid and night shift and lower Ramasy score.While the most important criteria predicting the need for reintubation were weak cough reflex, moderate and large amount of E/T secretions and the last PS delivered by the MV.Also, some new tests were studied to predict the need for reintubation in planned extubation group, DSA swallowing assessment, cuff leak test and minute ventilation recovery timeThe only independent predictor of reintubation was the minute ventilation recovery time and the longer recovery time the more reintubation.