Coppolo D P, May J J
Mary Imogene Bassett Hospital, Cooperstown, NY 13326.
Chest. 1990 Jul;98(1):165-9. doi: 10.1378/chest.98.1.165.
Unplanned removal of an endotracheal airway tube by a patient (SXT) represents a potentially life-threatening incident. Prospective monitoring of all intubated adult ICU patients for one year revealed that 12 of 112 extubated themselves (overall incidence, 11 percent). Comparison of SXT patients with the NXT group disclosed no risk factors for this occurrence. The proportion of patient-hours was similar when both groups were examined for tube size, tube site, ventilation mode and ventilator type. The mean hours of intubation was lower in the SXT group. Sixty-nine percent of unplanned extubations were deliberate; the majority of these occurred despite use of sedation and restraints. No death resulted from these events. The complication (and reintubation) rate in the SXT group was 31 percent. The reintubation rate in deliberate extubations was 11 percent. Self-extubation is a common occurrence which, despite obvious hazards, often is tolerated well by adults.
患者意外拔除气管内导管（SXT）是一种潜在的危及生命的事件。对所有成年ICU插管患者进行为期一年的前瞻性监测发现，112例中有12例自行拔管（总发生率为11%）。将SXT患者与非自行拔管（NXT）组进行比较，未发现导致这种情况的危险因素。当对两组患者的导管尺寸、导管位置、通气模式和呼吸机类型进行检查时，患者-小时数比例相似。SXT组的平均插管小时数较低。69%的意外拔管是故意的；其中大多数发生在使用镇静剂和约束措施的情况下。这些事件没有导致死亡。SXT组的并发症（和重新插管）发生率为31%。故意拔管的重新插管率为11%。自行拔管很常见，尽管存在明显风险，但成年人通常耐受性良好。
