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Outcome of non-invasive ventilation on unplanned extubation in the adult intensive care unit.

Author

William  E. del Poso,
Aileen G. Banzon,
Teresita S. de Guia

Related Institution

Division of Pulmonary and Critical Care Medicine - Philippine Heart Center

Publication Information

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Chest Diseases
Frequency
Trimester
Publication Date
January-April 2008
Volume
14
Issue
1
Page(s)
44-52

Abstract

Most patients who fail to tolerate unplanned extubation had been receiving full ventilatory support. Rapid reinstitution of ventilatory support and control of the airway of these patients may prevent the development or reduce the severity of complications. The act of re-intubation however is not without complications. To examine the impact of non-invasive ventilation (NIV) on unplanned extubation on hospital outcome, we performed an analysis of prospectively gathered data in a tertiary-care intensive care unit (ICU). We followed 240 ventilated patients over a nine-month period. Thirty-nine (16%) episodes of unplanned extubation were recorded. Nine (4%) episodes were excluded (four were hemodynamically unstable, three had unplanned extubation during a weaning trial, and two received oxygen therapy alone). Thirty (12.5%) occurred during full ventilatory support and were included (15 received NIV, 15 received IMV). Both groups were matched for age, sex, and presence of co-morbid conditions, indications for mechanical ventilation and Acute Physiologic and \ Chronic Health Evaluation II score. In-hospital mortality was similar in both groups (NIV 27%, versus IMV 40%, p=O.698). Patients who received NIV had a significantly shorted duration of ventilatory support (five versus 11d, p<O.05) and shorter stay in the ICU (12 versus 17d, p<O.05). There was no difference in overall hospital stay. Complications such as pneumonia were less common among the NIV group (3 versus 9) but this did not reach statistical significance (p=O.064). This study indicated that unplanned extubation during full ventilatory support can be successfully managed with noninvasive ventilation, providing measurable benefits on reduction of the duration of total ventilatory days and ICU stay.

Physical Location

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Box No. 115 Fulltext Print Format
Philippine Council for Health Research and Development Fulltext pdf (Request Document)

 
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