EM3 Unplanned extubations in asthma. (Emergency Medicine).EM3 UNPLANNED EXTUBATIONS IN ASTHMA. Mihai S. Jalba, MD, PhD, and Mohammed T. Alam, MD, MBBS MBBS, MBChB n abbr (BRIT) (= Bachelor of Medicine and Surgery) → título universitario MBBS, MBChB n abbr (Brit) (= Bachelor of Medicine and Surgery) → . Brooklyn Hospital, Brooklyn, NY. Weaning weaning, n the period of transition from breast feeding to eating solid foods. weaning the act of separating the young from the dam that it has been sucking, or receiving a milk diet provided by the dam or from artificial sources. from mechanical ventilation mechanical ventilation n. A mode of assisted or controlled ventilation using mechanical devices that cycle automatically to generate airway pressure. remains a physiologically complex and psychologically stressful process. Despite the hazards? unplanned extubations occur in some patients, either voluntarily or involuntarily, and they are associated with a greater risk of decease. Many of these patients have acute respiratory failure Respiratory Failure Definition Respiratory failure is nearly any condition that affects breathing function or the lungs themselves and can result in failure of the lungs to function properly. . The aim of this research is to study the characteristics of the intubated asthma patients, helping caregivers to prevent negative outcomes. To determine the risk factors for unplanned extubations, we retrospectively reviewed the medical charts of the last 24 consecutive intubated asthmatics admitted to our emergency department between 1998 and 2000. In this group of patients, 8 patients (33%) were male and 16 (66%) were female. There were 7 unplanned extubations. Five of them occurred in males (71.43%) and the other two occurred in females (28.57%). The intubated patients had an average hospitalization hospitalization /hos·pi·tal·iza·tion/ (hos?pi-t'l-i-za´shun) 1. the placing of a patient in a hospital for treatment. 2. the term of confinement in a hospital. period of 204 hours 38 minutes and an average intubation intubation /in·tu·ba·tion/ (in?too-ba´shun) the insertion of a tube into a body canal or hollow organ, as into the trachea. endotracheal intubation period of 75 hours 24 minutes. Th e unplanned extubated patients had an average hospitalization period of 159 hours 59 minutes and an average intubation period of 67 hours 7 minutes. In conclusion, male sex is identified as a risk factor for unplanned extubation. The unplanned extubated patients have a shorter intubation period and a shorter length of hospitalization. Psychologic differences in the asthma patients population might play a role in self-extubations, but research findings to date do not address the psychologic components of weaning and how they affect the weaning process. Additional studies on assessment tools are needed to guide caregivers on risk factors of unplanned extubations. |
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