The Effectiveness of Immediate Non-invasive Positive Pressure Ventilation on Decreasing the Re-intubation Rate of Unplanned Extubation

Unplanned extubation, or UE is a common event occurring in the ICU. UE will lead to many serious complications that may extend the duration of stay in the ICU and possibly patient mortality. The historical control study aimed to understand whether re-intubation rate in ICU patients with UE would decrease when given treatment from non-invasive positive pressure ventilation (NIPPV). 24 months retrospective collection of data from October 2006 to September 2008. 114 adult ICU patients, aged 18 years or older and qualified for use of intubation ventilation for more than 48 hours and with UE incidences, are designated as control group. From October 2008 to December of 2009, 62 cases were collected prospectively from 4 adult intensive care units, who developed UE and were given NIPPV immediately for over 8 hours. These cases were designated as the sample group. There were 40 patients from the sample group that did not require re-intubation (64.5%), and 54 patients in control group (47.4%). Statistical analysis revealed that the p value between the two groups was 0.029, showing that immediate administering NIPPV can significantly reduce the re-intubation rate needed for UE. Re-intubation may lead to secondary injury and increase incidence rates of clinical complications and mortality in patients with unplanned extubation. The immediate provision of NIPPV may be an effective measure to decrease the re-intubation needed for patients. (J Intern Med Taiwan 2012; 23: 351-359)