Anaesthesia Critical Care & Pain Medicine最新文献

{"title":"Combined hypoglossal and lingual nerve palsy: An unrecognized complication after orotracheal intubation for general anaesthesia. A case report of a day surgery patient and a literature review","authors":"Laure Cazenave ,&nbsp;Philippe Mahiou ,&nbsp;John Swan ,&nbsp;Philippe Clavert ,&nbsp;Johannes Barth","doi":"10.1016/j.accpm.2024.101418","DOIUrl":"10.1016/j.accpm.2024.101418","url":null,"abstract":"<div><div>Cranial nerve injury after orotracheal intubation is a rare complication, which has varied etiology. We present a case of combined unilateral hypoglossal and lingual nerve palsy after orotracheal intubation. The current literature was reviewed for the diagnostic, treatment, follow-up, and preventive measures of this complication.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 5","pages":"Article 101418"},"PeriodicalIF":3.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal use of videolaryngoscope for all intubations in the ICU: The time is now!","authors":"Clément Monet ,&nbsp;Philippe Richebé ,&nbsp;Samir Jaber","doi":"10.1016/j.accpm.2024.101417","DOIUrl":"10.1016/j.accpm.2024.101417","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 5","pages":"Article 101417"},"PeriodicalIF":3.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-flow nasal cannula and in-line aerosolised bronchodilator delivery during severe exacerbation of asthma in adults: a feasibility observational study","authors":"Nicolás Colaianni-Alfonso ,&nbsp;Ada Toledo ,&nbsp;Guillermo Montiel ,&nbsp;Mauro Castro-Sayat ,&nbsp;Claudia Crimi ,&nbsp;Luigi Vetrugno","doi":"10.1016/j.accpm.2024.101414","DOIUrl":"10.1016/j.accpm.2024.101414","url":null,"abstract":"<div><h3>Background</h3><div>Asthma is a common chronic respiratory disease affecting 1–29% of the population in different countries. Exacerbations represent a change in symptoms and lung function from the patient's usual condition that requires emergency department (ED) admission. Recently, the use of a High-Flow Nasal Cannula (HFNC) plus an in-line vibrating mesh nebulizer (VMN) for aerosol drug delivery has been advocated in clinical practice. Thus, this pilot observational study aims to investigate the feasibility of HFNC treatment with VMN for in-line bronchodilator delivery in patients with severe asthma.</div></div><div><h3>Methods</h3><div>This study was conducted from May 2022 to May 2023. Subjects ≥18 years old with a previous diagnosis of asthma who were admitted to the ED during severe exacerbation were included. The primary endpoint was the change in peak expiratory flow ratio (PEFR) after 2-h of treatment with bronchodilator delivered by HFNC with in-line VMN. Additional outcomes were changes in forced expiratory volume in 1 s (FEV₁) and clinical variables before treatment.</div></div><div><h3>Results</h3><div>30 patients, mean age of 43 (SD ± 16) years, mostly female (67%) were studied. A significant change in PEFR (147 ± 31 L/m <em>vs.</em> 220 ± 38 L/m; <em>p</em> &lt; 0.001) was observed after treatment with HFNC and in-line VMN with significant improvement in clinical variables. And no subjects required invasive mechanical ventilation (IMV) during the study.</div></div><div><h3>Conclusions</h3><div>HFNC treatment with in-line VMN for bronchodilator delivery appears feasible and safe for patients with severe asthma exacerbation. These preliminary promising results should be confirmed with appropriately large-designed studies.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 5","pages":"Article 101414"},"PeriodicalIF":3.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Pain Management in children: guidance from the Pain Committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative) Part II","authors":"Maria Vittinghoff ,&nbsp;Per Arne Lönnqvist ,&nbsp;Valeria Mossetti ,&nbsp;Stefan Heschl ,&nbsp;Dusica Simic ,&nbsp;Vesna Colovic ,&nbsp;Martin Hözle ,&nbsp;Marzena Zielinska ,&nbsp;Belen De Josè Maria ,&nbsp;Francesca Oppitz ,&nbsp;Diana Butkovic ,&nbsp;Neil S. Morton","doi":"10.1016/j.accpm.2024.101427","DOIUrl":"10.1016/j.accpm.2024.101427","url":null,"abstract":"<div><div>The ESPA Pain Management Ladder Initiative is a clinical practice advisory based upon expert consensus supported by the current literature to help ensure a basic standard of perioperative pain management for all children. In 2018 the perioperative pain management of six common pediatric surgical procedures was summarised. The current Pain Management Ladder recommendations focus on five more complex pediatric surgical procedures and suggest basic, intermediate, and advanced pain management methods. The aim of this paper is to encourage best possible pain management practice and to support institutions to create their own pain management concepts according to their financial and human resources due to the diversity of clinical settings in Europe. Furthermore, the authors underline that these recommendations are intended for inpatients only.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 6","pages":"Article 101427"},"PeriodicalIF":3.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dexmedetomidine versus propofol on outcomes in critically ill patients with different sedation depths: a propensity score-weighted cohort study","authors":"Hao-Chin Wang ,&nbsp;Chun-Jen Huang ,&nbsp;Shu-Fen Liao ,&nbsp;Ru-Ping Lee","doi":"10.1016/j.accpm.2024.101425","DOIUrl":"10.1016/j.accpm.2024.101425","url":null,"abstract":"<div><h3>Objective</h3><div>We explored the effects of dexmedetomidine (DEX) versus propofol on outcomes in critically ill patients and to assess whether these effects are dissimilar under different sedation depths.</div></div><div><h3>Methods</h3><div>A stabilized inverse probability of treatment weighting cohort study was conducted using data from the Medical Information Mart for Intensive Care IV database from 2008 to 2019. Adult intensive care unit (ICU) patients who were administered DEX or propofol as the primary sedative were identified. Various statistical methods were used to evaluate the effects of DEX versus propofol on outcomes.</div></div><div><h3>Results</h3><div>Data on 107 and 2318 patients in DEX and propofol groups, respectively, were analyzed. Compared to the propofol group, the DEX group exhibited longer ventilator-free days on day 28 and a shorter ICU stay. Conversely, it showed null associations of DEX with the risk of 90-day ICU mortality, the odds of persistent organ dysfunction on day 14 and acute kidney injury, and the duration of vasopressor-free days on day 28. Subgroup analyses revealed that DEX positively impacted persistent organ dysfunction on day 14, ventilator-free days on day 28, and ICU stay in the subgroup with a Richmond Agitation Sedation Scale (RASS) score of ≥−2. However, DEX negatively impacted 90-day ICU mortality, persistent organ dysfunction on day 14, and ventilator-free days on day 28 in the subgroup with a RASS score of &lt;−2.</div></div><div><h3>Conclusion</h3><div>Our results indicated that, compared with propofol, DEX had beneficial and adverse impacts on certain ICU outcomes in critically ill patients, and these impacts appeared to depend on sedation depths.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 6","pages":"Article 101425"},"PeriodicalIF":3.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic application of dexmedetomidine reduces the incidence of emergence delirium in children: A systematic review and meta-analysis","authors":"Sai-hao Fu ,&nbsp;Meng-rong Miao ,&nbsp;Lu-yao Zhang ,&nbsp;Jing Bian ,&nbsp;Yun-xiang Fu ,&nbsp;Jia-qiang Zhang ,&nbsp;Ming-yang Sun","doi":"10.1016/j.accpm.2024.101426","DOIUrl":"10.1016/j.accpm.2024.101426","url":null,"abstract":"<div><h3>Background</h3><div>Emergence delirium (ED) is a common postoperative cognitive dysfunction in children. ED may cause distress to patients and their families in the early post-anesthesia period and have long-term adverse effects on children.</div></div><div><h3>The primary purpose</h3><div>was to verify whether dexmedetomidine can reduce the occurrence of ED in children.</div></div><div><h3>Research type</h3><div>Systematic review and meta-analysis of RCTs.</div></div><div><h3>Data acquisition</h3><div>A search was conducted on Web of Science, WHO Trials, Cochrane Library, Clinical Trials.gov, and PubMed for all published studies from inception to 23 Oct. 2022.</div></div><div><h3>Eligibility criteria</h3><div>Randomized clinical trials that met the following criteria: patients aged 1–18 years, study site in the PACU (Post-anesthesia care unit), incidence of ED as the primary outcome, and prophylactic use of dexmedetomidine defined as injected before admission to the PACU.</div></div><div><h3>Results</h3><div>A total of 7 randomized trials were included (6 studies during eye and neck surgery, 1 during hernia surgery), involving 512 patients (257 (50.1%) with dexmedetomidine, and 250 (49.9%) with control. ED was observed in 17.51% of the patients treated with dexmedetomidine and in 43.14% of those receiving control (risk ratio (RR) = 0.40, 95 % confidence interval [CI] [0.30−0.55], <em>P</em> &lt; 0.00001). Additionally, the prophylactic application of dexmedetomidine also reduced the occurrence of Post-Operating Nausea and Vomiting (RR = 0.24, 95%CI [0.12−0.49], <em>P</em> = 0.0001) and PACU stay time after extubation (mean difference (MD) = −1.57, 95%CI [−3.07 to −0.07], <em>P</em> = 0.04). However, sensitivity analysis of RCTs showed that our effect estimates were not stable (MD = −1.78, 95%CI [−4.18−0.62], <em>P</em> = 0.15).</div></div><div><h3>Conclusion</h3><div>The prophylactic use of dexmedetomidine was associated with a reduction of ED. However, our findings only apply to eye and neck surgery.</div></div><div><h3>Trial registration</h3><div>PROSPERO: CRD42022371840.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 6","pages":"Article 101426"},"PeriodicalIF":3.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating StEP-COMPAC definition and enhanced recovery after surgery status in a machine-learning-based model for postoperative pulmonary complications in laparoscopic hepatectomy","authors":"Sibei Li ,&nbsp;Yaxin Lu ,&nbsp;Hong Zhang ,&nbsp;Chuzhou Ma ,&nbsp;Han Xiao ,&nbsp;Zifeng Liu ,&nbsp;Shaoli Zhou ,&nbsp;Chaojin Chen","doi":"10.1016/j.accpm.2024.101424","DOIUrl":"10.1016/j.accpm.2024.101424","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pulmonary complications (PPCs) contribute to high mortality rates and impose significant financial burdens. In this study, a machine learning-based prediction model was developed to identify patients at high risk of developing PPCs following laparoscopic hepatectomy.</div></div><div><h3>Methods</h3><div>Data were collected from 1022 adult patients who underwent laparoscopic hepatectomy at two centres between January 2015 and February 2021. The dataset was divided into a development set and a temporal external validation set based on the year of surgery. A total of 42 factors were extracted for pre-modelling, including the implementation status of Enhanced Recovery after Surgery (ERAS). Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) method. Model performance was assessed using the area under the receiver operating characteristic curve (AUC). The model with the best performance was externally validated using temporal data.</div></div><div><h3>Results</h3><div>The incidence of PPCs was 8.7%. Lambda.1se was selected as the optimal lambda for LASSO feature selection. For implementation of ERAS, serum gamma-glutamyl transferase levels, malignant tumour presence, total bilirubin levels, and age-adjusted Charleston Comorbidities Index were the selected factors. Seven models were developed. Among them, logistic regression demonstrated the best performance, with an AUC of 0.745 in the internal validation set and 0.680 in the temporal external validation set.</div></div><div><h3>Conclusions</h3><div>Based on the most recent definition, a machine learning model was employed to predict the risk of PPCs following laparoscopic hepatectomy. Logistic regression was identified as the best-performing model. ERAS implementation was associated with a reduction in the number of PPCs.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 6","pages":"Article 101424"},"PeriodicalIF":3.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of ventilation mode on postoperative pulmonary complications among intermediate- to high-risk patients undergoing abdominal surgery: A randomized controlled trial","authors":"Xuefei Li ,&nbsp;Yi Xu ,&nbsp;Zaili Wang ,&nbsp;Weiwei Wang ,&nbsp;Qiansu Luo ,&nbsp;Qianglin Yi ,&nbsp;Hai Yu","doi":"10.1016/j.accpm.2024.101423","DOIUrl":"10.1016/j.accpm.2024.101423","url":null,"abstract":"<div><h3>Background</h3><div>The effect of different mechanical ventilation modes on pulmonary outcome after abdominal surgery remains unclear. We evaluated the effects of three common ventilation modes on postoperative pulmonary complications (PPCs) among intermediate- to high-risk patients undergoing abdominal surgery.</div></div><div><h3>Methods</h3><div>This randomized clinical trial enrolled adult patients at intermediate or high risk of PPCs who were scheduled for abdominal surgery. Participants were randomized to receive one of three modes of mechanical ventilation modes: volume-controlled ventilation (VCV), pressure-controlled ventilation (PCV), and pressure-control with volume-guaranteed ventilation (PCV-VG). Lung-protective ventilation strategy was implemented in all groups. The primary outcome was the incidence of a composite of pulmonary complications within the first 7 postoperative days. Pulmonary complications within 30 postoperative days, the severity grade of PPCs, and other secondary outcomes were also analyzed.</div></div><div><h3>Results</h3><div>A total of 1365 patients were randomized and 1349 were analyzed. The primary outcome occurred in 98 (21.8%) in the VCV group, 95 (22.1%) in the PCV group, and 101 (22.5%) in the PCV-VG group (<em>P</em> = 0.865). Additionally, there were no statistically significant differences among the three groups in terms of the incidence of pulmonary complications within postoperative 30 days, severity grade of PPCs, and other secondary outcomes.</div></div><div><h3>Conclusion</h3><div>In intermediate- to high-risk patients undergoing abdominal surgery, the choice of ventilation mode did not affect the risk of PPCs.</div></div><div><h3>Trial Registration</h3><div>Chinese Clinical Trial Registry, entry ChiCTR1900025880.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 6","pages":"Article 101423"},"PeriodicalIF":3.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learned from the war in Ukraine for the anesthesiologist and intensivist: A scoping review","authors":"Audrey Jarrassier ,&nbsp;Nicolas Py ,&nbsp;Gaël de Rocquigny ,&nbsp;Mathieu Raux ,&nbsp;Sigismond Lasocki ,&nbsp;Clément Dubost ,&nbsp;Emmanuel Bordier ,&nbsp;Nicolas Libert ,&nbsp;Thomas Leclerc ,&nbsp;Éric Meaudre ,&nbsp;Pierre Pasquier","doi":"10.1016/j.accpm.2024.101409","DOIUrl":"10.1016/j.accpm.2024.101409","url":null,"abstract":"<div><h3>Background</h3><div>The war in Ukraine provides purposefully anesthesiologists and intensivists with important data for improving the management of trauma patients. This scoping review aims to investigate the specific management of war-related trauma patients, during the war in Ukraine, through an objective and comprehensive analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search of the Embase, Medline, and Open Grey databases from 2014 to February 2024 yielded studies focusing on anesthesia and surgery. These studies were assessed by PRISMA and STROBE criteria and needed to discuss anesthesiology and surgical procedures.</div></div><div><h3>Results</h3><div>Of the 519 studies identified, 21 were included, with a low overall level of evidence. The studies covered 11,622 patients and 2470 surgical procedures. Most patients were Ukrainian men, 25–63 years old, who had sustained severe injuries from high-energy weapons, such as multiple rocket systems and combat drones. These injuries included major abdominal, facial, and extremity traumas. The surgical procedures varied from initial debridement to complex reconstructions. Anesthesia management faced significant challenges, including resource scarcity and the need for quick adaptability. Evacuations of casualties were lengthy, complex, and often involved rail transportation. Hemorrhage control with tourniquets was critical but associated with many complications. The very frequent presence of multi-resistant organisms required dedicated preventive measures and appropriated treatments. The need for qualified human resources underscored the importance of civilian-military cooperation.</div></div><div><h3>Conclusion</h3><div>This scoping review provides original and relevant insights on the lessons learned from the ongoing war in Ukraine, which could be useful for anesthesiologists and intensivists.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 5","pages":"Article 101409"},"PeriodicalIF":3.7,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective multi-center evaluation of the incidence of unplanned extubation and its outcomes in French intensive care units. The Safe-ICU study","authors":"Jérémie Guillemin ,&nbsp;Benjamin Rieu ,&nbsp;Olivier Huet ,&nbsp;Léonie Villeret ,&nbsp;Stéphanie Pons ,&nbsp;Anne Bignon ,&nbsp;Quentin de Roux ,&nbsp;Raphaël Cinotti ,&nbsp;Vincent Legros ,&nbsp;Gaëtan Plantefeve ,&nbsp;Claire Dayhot-Fizelier ,&nbsp;Edris Omar ,&nbsp;Cyril Cadoz ,&nbsp;Fanny Bounes ,&nbsp;Cécile Caplin ,&nbsp;Karim Toumert ,&nbsp;Thibault Martinez ,&nbsp;Damien Bouvier ,&nbsp;Maxime Coutrot ,&nbsp;Thomas Godet ,&nbsp;Florian Blanchard","doi":"10.1016/j.accpm.2024.101411","DOIUrl":"10.1016/j.accpm.2024.101411","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to determine the epidemiology and outcomes of unplanned extubation (UE), both accidental and self-extubation, in ICU.</div></div><div><h3>Methods</h3><div>A multicentre prospective cohort study was conducted in 47 French ICUs. The number of mechanical ventilation (MV) days, and planned and unplanned extubation were recorded in each center over a minimum period of three consecutive months to evaluate UE incidence. Patient characteristics, UE environmental factors, and outcomes were compared based on the UE mechanism (accidental or self-extubation). Self-extubation outcomes were compared with planned extubation using a propensity-matched population. Finally, risk factors for extubation failure (re-intubation before day 7) were determined following self-extubation.</div></div><div><h3>Results</h3><div>During the 12-month inclusion period, we found a pooled UE incidence of 1.0 per 100 MV days. UE accounted for 9% of all endotracheal removals. Of the 605 UE, 88% were self-extubation and 12% were accidental-extubations. The latter had a worse prognosis than self-extubation (34% <em>vs.</em> 8% ICU-mortality, <em>p</em> &lt; 0.001). Self-extubation did not increase mortality compared with planned extubation (8% <em>vs.</em> 11%, <em>p</em> = 0.075). Regardless of the type of extubation, planned or unplanned, extubation failure was independently associated with a poor outcome. Cancer, higher respiratory rate, lower PaO₂/FiO₂ at the time of extubation, weaning process not-ongoing, and immediate post-extubation respiratory failure were independent predictors of failed self-extubation.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 5","pages":"Article 101411"},"PeriodicalIF":3.7,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}