Minda Zewdu, Samuel Hirbo, Aweke Senayit, Mekete Getachew, Seid Abdurehman, Eshetie Denberu
Department of Anesthesia, Saint Pitter Specialized Hospital, Addis Ababa, Ethiopia.
Department of Anesthesia, Addis Ababa University, School of Medicine, Addis Ababa, Ethiopia.
Ann Med Surg (Lond). 2022 Jun 8;79:103936. doi: 10.1016/j.amsu.2022.103936. eCollection 2022 Jul.
Unplanned extubation is the removal of an endotracheal tube accidently during procedural activities or by the action of the patient. It is one of the commonly reported complications among mechanically ventilated patients in the intensive care unit. This study aimed to assess the magnitude and associated factors of unplanned extubation in intensive care units at referral hospitals in Addis Ababa, Ethiopia, 2021.
Institutional based prospective observational study was conducted on 317 intubated patients in the intensive care unit at referral hospitals of Addis Ababa, Ethiopia, from January 8, 2021-May 9, 2021. Data were collected using a structured questionnaire. Descriptive statics were expressed in percentages and presented with tables and figures. Both Bivariable and multivariable logistic analysis was done to identify factors associated with unplanned extubation in intensive care unit. P < 0.05 with 95% CI was set as Statistical significance.
The prevalence of unplanned extubation in this study was 19.74%. Being male (AOR = 3.132, 95%CI: 1.276-7.69), duration of intubation <5days (AOR = 2.475, 95% CI: 1.039-5.894), managed by junior resident (AOR = 5.25, 95% CI: 2.125-12.969), being physically restrained (AOR = 4.356, 95%CI: 1.786-10.624), night shift (AOR = 3.282, 95%CI:1.451-7.424)and agitation (AOR = 4.934,95%CI:1.934-12.586) were significantly contribute to the occurrence of unplanned extubation.
and recommendation: This study showed that the prevalence of unplanned extubation was high in the intensive care unit. We suggest to intensive care unit staff to give special attention to early intubated patients, especially male individuals and the stakeholders of hospitals should rearrange the time of shift and physician schedules in the intensive care unit.
非计划性拔管是指在诊疗活动过程中或患者自行操作导致气管内导管意外拔除。这是重症监护病房中机械通气患者常见的并发症之一。本研究旨在评估2021年埃塞俄比亚亚的斯亚贝巴转诊医院重症监护病房非计划性拔管的发生率及相关因素。
于2021年1月8日至2021年5月9日在埃塞俄比亚亚的斯亚贝巴转诊医院的重症监护病房对317例插管患者进行了基于机构的前瞻性观察研究。使用结构化问卷收集数据。描述性统计以百分比表示，并以表格和图表呈现。进行了双变量和多变量逻辑分析，以确定重症监护病房中与非计划性拔管相关的因素。设定P < 0.05且95%置信区间为具有统计学意义。
本研究中非计划性拔管的发生率为19.74%。男性（比值比[AOR]=3.132，95%置信区间：1.276 - 7.69）、插管时间<5天（AOR = 2.475，95%置信区间：1.039 - 5.894）、由低年资住院医师管理（AOR = 5.25，95%置信区间：2.125 - 12.969）、使用身体约束（AOR = 4.356，95%置信区间：1.786 - 10.624）、夜班（AOR = 3.282，95%置信区间：1.451 - 7.424）和躁动（AOR = 4.934，95%置信区间：1.934 - 12.586）均显著促成非计划性拔管的发生。
本研究表明重症监护病房中非计划性拔管的发生率较高。我们建议重症监护病房工作人员特别关注早期插管患者，尤其是男性患者，并且医院相关部门应重新安排重症监护病房的轮班时间和医生排班。
