THE ASSOCIATION BETWEEN DELAYED SPONTANEOUS BREATHING TRIALS AND UNPLANNED EXTUBATIONS: QUALITY IMPROVEMENT INITIATIVE

TOPIC: Critical Care TYPE: Original Investigations PURPOSE: An unplanned extubation is a serious event in the intensive care unit (ICU). It has been associated with complications which may account for an increase morbidity and mortality. Understanding surrounding variables mechanisms at play that put intubated patient risk these events vital to prevent future extubation. This study was undertaken identify contributing extubations critically ill patients create targeted quality improvement initiative aim decrease rate of METHODS: As part initiative, retrospective cohort all performed 1025-bed tertiary center across five different specialty ICUs including medical, surgical, cardiothoracic, neurological, bone marrow transplant unit, from January 2019 December 2020. Clinical data collected each patient’s chart age, gender, history substance use, reason intubation, type service, length stay, timing event, sedative medication use time extubation, level sedation, restraints attempt on spontaneous breathing trial (SBT), immediate team incidence reintubation. Data organized into two-by-two contingency tables, stratifying reintubation versus no necessity. Frequency counts subgroup were examined, statistical significance calculated using Fisher’s Exact Test. RESULTS: A total 55 evaluated. The mean age population 49 years old. 34 male (62%) 21 female (38%). 22 (40%) required Age, service not statistically significant predictors need after (p=0.21, 0.61, 0.43, 0.12 respectively) as well sedation (p=0.087 0.44 respectively). Among who requiring reintubation, SBT (95%) only 1 (5%) self-extubated while SBT. However, among 33 (60%) 27 (82%) 18 (18%) CONCLUSIONS: From our study, (49%) had being full support mode ventilation. finding raised suspicion delayed liberation ventilator leads unnecessarily prolonged intubation. One hypotheses might be underutilized. we limited by small sample size unaccounted confounders given nature study. CLINICAL IMPLICATIONS: Our suggests there room improve weaning protocol ICU. proposed strategies implemented include utilizing prediction model are likely undergo successfully expedite process those patients, creating standardized protocol, education nursing staffs respiratory therapists, especially assessment patient's readiness weaned mechanical ventilatory importance performing daily DISCLOSURES: No relevant relationships Maythawee Bintvihok, source=Web Response Jessica Kent, Denizen Kocak, Adan (Adam) Mora, Jiesu Sun, Ciara Wisecup,