Respiratory failure & ventilation
Prospective multi-center evaluation of the incidence of unplanned extubation and its outcomes in French intensive care units. The Safe-ICU study
Authors' conclusion
Unplanned extubation, mostly represented by self-extubation, is common in ICU and accounts for 9% of all endotracheal extubations. While accidental extubations are a serious and infrequent adverse event, self-extubation does not increase mortality compared to planned extubation.
Study context
- Population
- Mechanically ventilated patients in 47 French ICUsUnplanned extubation (UE)
- Participants
- 605 participants
- Exposure
- Accidental vs self-extubation; self-extubation vs planned extubation
- Outcome
- Incidence of unplanned extubation (UE) per 100 MV days
Methodological detailsmulticentre, propensity-matched comparison, Minimum three consecutive months of recording per centre; 12-month inclusion period
- Multicentre
- Propensity-matched comparison
- Minimum three consecutive months of recording per centre; 12-month inclusion period
Main finding
As reported in the abstract
UE incidence
Pooled UE incidence per 100 mechanical ventilation (MV) days
1.0
UE share of all endotracheal removals
9%
Self-extubation share of UE
88%
Accidental extubation share of UE
12%
Observational data: associations, not effects.
Further findings
| Outcome | Self-extubation | Accidental extubation | Planned extubation | P value |
|---|---|---|---|---|
| ICU mortality, accidental vs self-extubation | 8% | 34% | — not stated in the abstract | P < 0.001 |
| Mortality, self-extubation vs planned extubationPropensity-matched population | 8% | — not stated in the abstract | 11% | P = 0.075 |
— not stated in the abstract
Extubation failure (re-intubation before day 7)
- Independently associated with poor outcome regardless of extubation type
- Independent predictors of failed self-extubation: cancer, higher respiratory rate, lower PaO2/FiO2 at extubation, weaning not ongoing, immediate post-extubation respiratory failure
Original publication
Prospective multi-center evaluation of the incidence of unplanned extubation and its outcomes in French intensive care units. The Safe-ICU study. Anaesth Crit Care Pain Med. Published 30 July 2024. doi:10.
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